NPIMap

Organization Active NPI

TCM Wellness Clinic

  • Acupuncturist
  • Spring Park, MN
National Provider Identifier
1508249699
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1543 Issued in MN
Legal business name
TCM WELLNESS CLINIC
Practice address
4661 Shoreline Dr
Spring Park, MN 55384-9715
Phone
(612) 965-5227
NPI assigned
Jul 7, 2015
Last updated
Jul 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Nichole VanecekNPI 1891074514
Title
Acupuncture Physician
Phone
(612) 965-5227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1543 MN Primary

Addresses

Primary practice location

4661 Shoreline Dr
Spring Park, MN 55384-9715

Mailing address

4661 Shoreline Dr
Spring Park, MN 55384-9715

National Provider Directory

National Provider Directory

Locations

4661 Shoreline Dr
Spring Park, MN 55384
Phone (307) 337-7321

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1508249699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4661 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4661 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849715",
            "telephone_number": "612-965-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TCM WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "VANECEK",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "ACUPUNCTURE PHYSICIAN",
        "authorized_official_telephone_number": "612-965-5227"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.