Active NPI
Kimberly Deterding, LAC; LMT
- Acupuncturist
- Independence, IA
National Provider Identifier
1407262801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- A-138
- Practice address
- 111 1St St E
Independence, IA 50644-2806 - Phone
- (319) 231-9545
- NPI assigned
- Jul 7, 2014
- Last updated
- Oct 9, 2025
- Sex
- Female
- 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 | A-138 | IA | Primary |
| Massage Therapist | 225700000X | 007159 | IA |
Addresses
Primary practice location
111 1St St E
Independence, IA 50644-2806
Mailing address
3336 Kimball Ave Ste 150B
Waterloo, IA 50702-5762
Phone (319) 231-9545
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 |
|---|---|---|---|
| A-138 | IA | MD | Acupuncturist |
| 007159 | IA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1407262801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3336 KIMBALL AVE STE 150B",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025762",
"telephone_number": "319-231-9545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 1ST ST E",
"city": "INDEPENDENCE",
"state": "IA",
"postal_code": "506442806",
"telephone_number": "319-231-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETERDING",
"first_name": "KIMBERLY",
"credential": "LAC; LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-07",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IA",
"license": "A-138",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IA",
"license": "007159",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, IA
- Cornerstone Family Therapy, LLC
- Counseling and Assessment Service, PC
- County of Buchanan (Buchanan County Ambulance Service)
- Bhasker Jethalal Dave, MD
- Randolfo De Leon, M.D.
- Sarah Rae Devore, ARNP
- Connie R Divis, RPH
- Dr Mark M Zimmer PC (Belle Plaine Family Eyecare)
- Dr. Mark M. Zimmer P.C
- Emerald Bridges Family Therapy, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.