Active NPI
Shawn Frederick Kissick, L.AC.
- Acupuncturist
- Beaver, PA
National Provider Identifier
1346498086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AK000926
- Practice address
- 455 3Rd St Apt 2
Beaver, PA 15009-2266 - Phone
- (724) 774-8729
- Fax
- (878) 201-3089
- NPI assigned
- Sep 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AK000926 | PA | Primary |
Addresses
Primary practice location
455 3Rd St Apt 2
Beaver, PA 15009-2266
Mailing address
320 College Ave
Beaver, PA 15009-2283
Phone (724) 774-8729
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
| License | State | Type | Specialty |
|---|---|---|---|
| AK000926 | PA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Free Spirit Acupuncture & Wellness Center | Acupuncturist | Past | Accepting new patients |
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.
-
- Acupuncturist
- Beaver, PA
- NPI 1336652536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542672000000",
"number": "1346498086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 COLLEGE AVE",
"city": "BEAVER",
"state": "PA",
"postal_code": "150092283",
"telephone_number": "724-774-8729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 3RD ST APT 2",
"city": "BEAVER",
"state": "PA",
"postal_code": "150092266",
"telephone_number": "724-774-8729",
"fax_number": "878-201-3089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISSICK",
"first_name": "SHAWN",
"middle_name": "FREDERICK",
"name_prefix": "Mr.",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-06",
"last_updated": "2018-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "AK000926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.