Madison Integrative Medicine Alliance, Inc

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

232 Issued in WI

Legal business name

MADISON INTEGRATIVE MEDICINE ALLIANCE, INC

Practice address

6255 University Ave
Suite 202
Middleton, WI 53562-3485

Phone

(608) 238-3333

Fax

(608) 238-3374

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Song, OMD, MD, PHD, LACNPI 1336265495

Title

President

Phone

(608) 238-3333

Specialties & licenses 2

Addresses

Other names 1

• Beijing Acupuncture & Chinese Herbal Medicine Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Song, OMD, MD, PHD, LAC

  • Acupuncturist
  • Middleton, WI
  • NPI 1336265495
  NPD (past) Authorized official
• Leaf Ye Song, OMD, MS, LAC

  • Acupuncturist
  • Middleton, WI
  • NPI 1730205584
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366568412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "SUITE 202",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623485",
            "telephone_number": "608-238-3333",
            "fax_number": "608-238-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "SUITE 202",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623485",
            "telephone_number": "608-238-3333",
            "fax_number": "608-238-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON INTEGRATIVE MEDICINE ALLIANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-238-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OMD, MD, PHD, LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "232",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beijing Acupuncture & Chinese Herbal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Todd Andrew Lynch, O.D.
• Donal Grant Maccoon, PH.D.
• Christopher Mackay, DPT
• Madison Birth Center
• Madison Institute of Neurological Disorders, SC
• Madison Psychiatric Associates, LTD.
• Madison Vein and Laser Institiute, S.C.
• Courtney Maher, OTR/L
• David J Maiers
• Ashley M Malm, PHYSICAL THERAPIST

• Acupuncturist in Middleton, WI
• Providers in Middleton, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.