NPIMap

Organization Active NPI

Elemental Source Acupuncture, LLC

  • Acupuncturist
  • Frederick, MD
National Provider Identifier
1477096741
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
ELEMENTAL SOURCE ACUPUNCTURE, LLC
Practice address
263 W Patrick St
Suite 2
Frederick, MD 21701-6910
Phone
(240) 432-7522
NPI assigned
Nov 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Authorized official

Name
Kallie Guimond, M.OMNPI 1871035139
Title
Owner/Licensed Acupuncturist
Phone
(240) 432-7522

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
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X MD Primary

Addresses

Primary practice location

263 W Patrick St
Suite 2
Frederick, MD 21701-6910

Mailing address

3627 Lew Wallace St
Frederick, MD 21704-7872
Phone (240) 432-7522

National Provider Directory

National Provider Directory

Locations

263 W Patrick St
Ste 2
Frederick, MD 21701
Phone (240) 432-7522

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": "1479427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1477096741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 LEW WALLACE ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047872",
            "telephone_number": "240-432-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W PATRICK ST",
            "address_2": "SUITE 2",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016910",
            "telephone_number": "240-432-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTAL SOURCE ACUPUNCTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "GUIMOND",
        "authorized_official_first_name": "KALLIE",
        "authorized_official_title_or_position": "OWNER/LICENSED ACUPUNCTURIST",
        "authorized_official_telephone_number": "240-432-7522",
        "authorized_official_credential": "M.OM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.