Active NPI
Siddhartha M. G. Hannibal Wolong, LAC.
- Acupuncturist
- Litchfield, MN
National Provider Identifier
1437754801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1695
- Practice address
- 329 E Highway 12
Litchfield, MN 55355-2295 - Phone
- (320) 699-0161
- NPI assigned
- Dec 2, 2020
- Last updated
- Dec 2, 2020
- 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 | 1695 | MN | Primary |
Addresses
Primary practice location
329 E Highway 12
Litchfield, MN 55355-2295
Mailing address
329 E Highway 12
Litchfield, MN 55355-2295
Phone (320) 699-6061
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1695 | Other | MN | STATE OF MN MINNESOTA BOARDS OF MEDICAL PRACTICE |
| P146113245311 | Other | MN | DRIVERS LICENSE |
Other names 1
- James Joseph Franco
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Sleepingdragonacupuncture@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
| License | State | Type | Specialty |
|---|---|---|---|
| 1695 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1437754801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 E HIGHWAY 12",
"city": "LITCHFIELD",
"state": "MN",
"postal_code": "553552295",
"telephone_number": "320-699-6061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 E HIGHWAY 12",
"city": "LITCHFIELD",
"state": "MN",
"postal_code": "553552295",
"telephone_number": "320-699-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLONG",
"first_name": "SIDDHARTHA",
"middle_name": "M. G. HANNIBAL",
"credential": "LAC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1695",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MN MINNESOTA BOARDS OF MEDICAL PRACTICE",
"identifier": "1695",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "P146113245311",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Sleepingdragonacupuncture@gmail.com",
"affiliation": "N",
"endpointDescription": "business email",
"address_1": "329 E Highway 12",
"city": "Litchfield",
"state": "MN",
"country_code": "US",
"postal_code": "553552295",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JAMES",
"last_name": "FRANCO",
"middle_name": "JOSEPH",
"credential": "HANNIBAL WOLONG LAC.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Litchfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.