Shakti Clinic of Oriental Medicine

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1136 Issued in MN

Legal business name

SHAKTI CLINIC OF ORIENTAL MEDICINE

Practice address

4533 Louisiana Ave N
Crystal, MN 55428-5026

Phone

(763) 536-9350

NPI assigned

Dec 23, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Cassandra Kay Roberson, L.AC.NPI 1639257801

Title

Owner Practitioner

Phone

(763) 536-9350

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cassandra Kay Roberson, L.AC.

  • Acupuncturist
  • Minneapolis, MN
  • NPI 1639257801
  NPD (past) Authorized official

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558426221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 LYNDALE AVE S STE E",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082152",
            "telephone_number": "763-536-9350",
            "fax_number": "763-536-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 LOUISIANA AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554285026",
            "telephone_number": "763-536-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKTI CLINIC OF ORIENTAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER  PRACTITIONER",
        "authorized_official_telephone_number": "763-536-9350",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashanti Rayme Schlichenmayer
• Neil Schloner, ABOC
• Senative Services LLC
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• Lisa M Shakerin, MD
• Khalid Hussein Sharif
• Simac Professional Business Services, Inc.
• Joshua Oneal Simmons
• Shannon Renee Smaaladen
• David C Smiley, MD

• Acupuncturist in Crystal, MN
• Providers in Crystal, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.