Healthy Life Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

HEALTHY LIFE ACUPUNCTURE LLC

Practice address

808 Dunlawton Ave Ste 3
Port Orange, FL 32127-9284

Phone

(386) 767-7366

Fax

(386) 200-6263

NPI assigned

Apr 14, 2021

Last updated

Apr 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Bushelon, AP, DOMNPI 1477790988

Title

Owner

Phone

(138) 676-7736

Specialties & licenses 1

Addresses

Other names 1

• Healthy Life Acupuncture LLC Other name

Locations

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.

• Gina Beth Bushelon, DOM, A.P.

  • Acupuncturist
  • Port Orange, FL
  • NPI 1477790988
  NPD Authorized official

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1538740386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 DUNLAWTON AVE STE 3",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279284",
            "telephone_number": "386-767-7366",
            "fax_number": "386-200-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 DUNLAWTON AVE STE 3",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279284",
            "telephone_number": "386-767-7366",
            "fax_number": "386-200-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "BUSHELON",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "138-676-7736",
        "authorized_official_credential": "AP, DOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Life Acupuncture LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.