Active NPI
Kirk L Elliott, LAC, DIPL OM
- Acupuncturist
- Wynnewood, PA
National Provider Identifier
1376815811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AK000934
- Practice address
- 417 Cotswold LN
Wynnewood, PA 19096-2301 - Phone
- (610) 585-8628
- NPI assigned
- Jan 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | AK000934 | PA | Primary |
Addresses
Primary practice location
417 Cotswold LN
Wynnewood, PA 19096-2301
Mailing address
417 Cotswold LN
Wynnewood, PA 19096-2301
Phone (610) 585-8628
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 |
|---|---|---|---|
| AK000934 | PA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327881600000",
"number": "1376815811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 COTSWOLD LN",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190962301",
"telephone_number": "610-585-8628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 COTSWOLD LN",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190962301",
"telephone_number": "610-585-8628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "KIRK",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "LAC, DIPL OM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-30",
"last_updated": "2012-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "AK000934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.