Amy Marie Dolan, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1519 Issued in MN

Practice address

304 N Pokegama Ave Ste 100
Grand Rapids, MN 55744-2745

Phone

(218) 398-0550

NPI assigned

Jun 13, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amy Marie Kaiser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwoods Acupuncture and Wellness Canter

  • Acupuncturist
  • Grand Rapids, MN
  • NPI 1336979764
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1336709203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N POKEGAMA AVE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442745",
            "telephone_number": "218-398-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N POKEGAMA AVE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442745",
            "telephone_number": "218-398-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KAISER",
            "middle_name": "MARIE",
            "credential": "L.AC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acupuncturist in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.