Carlton Andrew Kelch, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC183849 Issued in OR

Practice address

3025 SW Corbett Ave
Portland, OR 97201-4858

Phone

(503) 552-1551

NPI assigned

Sep 11, 2017

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wise Mountain Medicine LLC

  • Clinic/Center
  • Bend, OR
  • NPI 1316512049
  NPD Authorized official

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1558880575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 NW HILL ST APT 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031373",
            "telephone_number": "970-406-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SW CORBETT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972014858",
            "telephone_number": "503-552-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELCH",
        "first_name": "CARLTON",
        "middle_name": "ANDREW",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC183849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liam G Keith
• Keivan Jinnah, ND, Lac, PC (Natural Choices Health Clinic)
• Heather A. Keizur, LMFT INTERN
• Andrea Kekahuna
• Jade Funtanilla Kekaualua, FNP
• Amy C Kelchner, N.D.
• Kelemental Health, PLLC
• Ryan Henry Kell, MSW
• Katrina Kellar, ATC, OTC
• Olivia M. Kellar, LAC, MACOM, LMT

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.