Active NPI
Kyle Wooten, LAC
- Acupuncturist
- Kuna, ID
National Provider Identifier
1396305504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- ACU-361
- Practice address
- 190 W Main St
Kuna, ID 83634 - Phone
- (208) 962-1849
- NPI assigned
- Jun 19, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 006550 | NY | |
| Acupuncturist | 171100000X | ACU-361 | ID | Primary |
Addresses
Primary practice location
190 W Main St
Kuna, ID 83634
Mailing address
PO Box 164
Kuna, ID 83634-0164
Phone (208) 962-1849
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 |
|---|---|---|---|
| ACU-361 | ID | MD | Acupuncturist |
| 006550 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1396305504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 164",
"city": "KUNA",
"state": "ID",
"postal_code": "836340164",
"telephone_number": "208-962-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 W MAIN ST",
"city": "KUNA",
"state": "ID",
"postal_code": "83634",
"telephone_number": "208-962-1849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN",
"first_name": "KYLE",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-19",
"last_updated": "2023-11-30",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006550",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "ID",
"license": "ACU-361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.