Mke Mindbody Wellness Inc.

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

MKE MINDBODY WELLNESS INC.

Practice address

3174 S Howell Ave
Milwaukee, WI 53207-2625

Phone

(414) 367-7023

NPI assigned

Oct 11, 2018

Last updated

Oct 11, 2018By 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

Aleisha Anderson, L.AC

Title

Acupuncturist

Phone

(414) 367-7023

Specialties & licenses 5

Addresses

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.

• Amanda Gawrysz, L.AC., MSOM

  • Acupuncturist
  • Milwaukee, WI
  • NPI 1376109496
  NPD (past)

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1548735087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3174 S HOWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072625",
            "telephone_number": "414-367-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3174 S HOWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072625",
            "telephone_number": "414-367-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKE MINDBODY WELLNESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ALEISHA",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "414-367-7023",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.