Individual provider Active NPI

Michael Kowalski, A.P., DR. AC.

  • Acupuncturist
  • Jacksonville, FL
National Provider Identifier
1346488756
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP208 Issued in FL
Practice address
4540 Southside Blvd Ste 302
Jacksonville, FL 32216-5488
Phone
(904) 703-6211
Fax
(904) 296-9547
NPI assigned
Jan 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP208 FL Primary

Addresses

Primary practice location

4540 Southside Blvd Ste 302
Jacksonville, FL 32216-5488

Mailing address

4540 Southside Blvd Ste 302
Jacksonville, FL 32216-5488
Phone (904) 703-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP208FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture & Holistic Health Center Acupuncturist CurrentSince Jul 21, 2024 Accepting new patients

Locations

4540 Southside Blvd
Ste 302
Jacksonville, FL 32216
Phone (904) 296-9545

4237 Salisbury Rd
Ste 107
Jacksonville, FL 32216
Phone (904) 296-9545

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1346488756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "904-703-6211",
            "fax_number": "904-296-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "904-703-6211",
            "fax_number": "904-296-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "MICHAEL",
        "credential": "A.P., DR. AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.