Individual provider Active NPI

Kenneth Eugene Harbour, L.AC. DIPL.AC

  • Acupuncturist
  • Forest, VA
National Provider Identifier
1619208428
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
0121000516 Issued in VA
Practice address
18478 Forest Rd Ste 3
Forest, VA 24551-4302
Phone
(434) 316-9101
NPI assigned
Jan 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0121000516 VA Primary
Mechanotherapist 172M00000X 0019002638 VA

Addresses

Primary practice location

18478 Forest Rd Ste 3
Forest, VA 24551-4302

Mailing address

PO Box 4799
Lynchburg, VA 24502-0799
Phone (434) 200-9144

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

LicenseStateTypeSpecialty
0121000516VAMDAcupuncturist
0019002638VAMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1619208428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4799",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245020799",
            "telephone_number": "434-200-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18478 FOREST RD STE 3",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514302",
            "telephone_number": "434-316-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBOUR",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "L.AC.  DIPL.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-18",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000516",
            "primary": true
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "VA",
            "license": "0019002638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.