Active NPI
Kevin B Shoemake, B.N., MSOM, LAC.
- Acupuncturist
- Hartland, WI
National Provider Identifier
1609173756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 692-055
- Practice address
- 114 W Capitol Dr
Hartland, WI 53029-2042 - Phone
- (262) 563-8022
- NPI assigned
- Feb 24, 2011
- Sex
- Male
- 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 | 692-055 | WI | Primary |
Addresses
Primary practice location
114 W Capitol Dr
Hartland, WI 53029-2042
Mailing address
114 W Capitol Dr
Hartland, WI 53029-2042
Phone (262) 563-8022
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
- Credentials
- Bachelor of Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 692-055 | WI | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298505600000",
"number": "1609173756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 W CAPITOL DR",
"city": "HARTLAND",
"state": "WI",
"postal_code": "530292042",
"telephone_number": "262-563-8022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 W CAPITOL DR",
"city": "HARTLAND",
"state": "WI",
"postal_code": "530292042",
"telephone_number": "262-563-8022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOEMAKE",
"first_name": "KEVIN",
"middle_name": "B",
"credential": "B.N., MSOM, LAC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-24",
"last_updated": "2011-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "692-055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartland, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.