Active NPI
Mary Runyan
- Acupuncturist
- Jacksonville, FL
National Provider Identifier
1548333263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AP 1394
- Practice address
- 1309 Saint Johns Bluff Rd N Ste 101 BLDG B
Jacksonville, FL 32225-8396 - Phone
- (904) 745-1735
- Fax
- (904) 745-3234
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- 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 | AP 1394 | FL | Primary |
Addresses
Primary practice location
1309 Saint Johns Bluff Rd N Ste 101 BLDG B
Jacksonville, FL 32225-8396
Mailing address
4253 Covered Creek CT
Jacksonville, FL 32277-1444
Phone (904) 745-3934
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 |
|---|---|---|---|
| AP 1394 | FL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548333263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4253 COVERED CREEK CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771444",
"telephone_number": "904-745-3934",
"fax_number": "904-745-3234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 SAINT JOHNS BLUFF RD N STE 101 BLDG B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322258396",
"telephone_number": "904-745-1735",
"fax_number": "904-745-3234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNYAN",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "AP 1394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.