Organization Active NPI

Balance Art Wellness Center PLLC

  • Health Service Clinic/Center
  • Vienna, VA
National Provider Identifier
1417687419
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
BALANCE ART WELLNESS CENTER PLLC
Practice address
301 Maple Ave W Ste 210
Vienna, VA 22180-4301
Phone
(786) 532-4722
NPI assigned
Jun 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Run Guo, L.ACNPI 1659810794
Title
Ceo
Phone
(786) 532-4722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

301 Maple Ave W Ste 210
Vienna, VA 22180-4301

Mailing address

301 Maple Ave W Ste 210
Vienna, VA 22180-4301

Other identifiers 1

IdentifierTypeStateIssuer
0121000840OtherVAACUPUNCTURE

National Provider Directory

National Provider Directory

Locations

301 Maple Ave W
Ste 210
Vienna, VA 22180
Phone (703) 268-5558

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1417687419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 210",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 210",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301",
            "telephone_number": "786-532-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE ART WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "GUO",
        "authorized_official_first_name": "RUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-532-4722",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "0121000840",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.