Individual provider Active NPI

Addie R. Harbin, LAC, DACM, MACOM

  • Acupuncturist
  • Missoula, MT
National Provider Identifier
1396990982
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
MED-ACU-LIC-60748 Issued in MT
Practice address
1753 S 14TH St W
Missoula, MT 59801-4923
Phone
(503) 853-2517
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01216 OR
Acupuncturist 171100000X MED-ACU-LIC-60748 MT Primary

Addresses

Primary practice location

1753 S 14TH St W
Missoula, MT 59801-4923

Mailing address

1753 S 14TH St W
Missoula, MT 59801-4923
Phone (503) 853-2517

Other practice location 1

130 NW Miller Ave
Gresham, OR 97030-7226
Phone (503) 665-2344

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL addieharbin.lac@gmail.com

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
MED-ACU-LIC-60748MTMDAcupuncturist
AC01216ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1396990982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 S 14TH ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014923",
            "telephone_number": "503-853-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 S 14TH ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014923",
            "telephone_number": "503-853-2517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 NW Miller Ave",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970307226",
            "country_code": "US",
            "telephone_number": "503-665-2344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARBIN",
        "first_name": "ADDIE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "LAC, DACM, MACOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01216",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MT",
            "license": "MED-ACU-LIC-60748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "addieharbin.lac@gmail.com",
            "affiliation": "N",
            "address_1": "1753 S 14th St W",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598014923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.