Active NPI
Ki Hyun Chang, L.AC
- Acupuncturist
- Stillwater, MN
National Provider Identifier
1487833398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1408
- Practice address
- 14791 60TH St N Ste 6
Stillwater, MN 55082-6382 - Phone
- (651) 430-3600
- Fax
- (651) 430-0900
- NPI assigned
- Oct 26, 2007
- 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 | 1408 | MN | Primary |
Addresses
Primary practice location
14791 60TH St N Ste 6
Stillwater, MN 55082-6382
Mailing address
1870 Windjammer Dr
Woodbury, MN 55125-8658
Phone (651) 730-5494
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 |
|---|---|---|---|
| 1408 | MN | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eternal Spring Acupuncture Inc | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Acupuncturist
- Stillwater, MN
- NPI 1770771123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1487833398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1870 WINDJAMMER DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551258658",
"telephone_number": "651-730-5494",
"fax_number": "651-430-0900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14791 60TH ST N STE 6",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550826382",
"telephone_number": "651-430-3600",
"fax_number": "651-430-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "KI",
"middle_name": "HYUN",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-26",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.