Individual provider Active NPI

Phranque Wright, DAOM

  • Acupuncturist
  • Chicago, IL
National Provider Identifier
1619384575
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198.000782 Issued in IL
Practice address
4007 N Broadway St
107
Chicago, IL 60613-6074
Phone
(708) 297-5899
NPI assigned
Jul 11, 2014
Last updated
Jul 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198.000782 IL Primary
Acupuncturist 171100000X 578-055 WI
Acupuncturist 171100000X 578 CO
Acupuncturist 171100000X 84000096A IN

Addresses

Primary practice location

4007 N Broadway St
107
Chicago, IL 60613-6074

Mailing address

4007 N Broadway St
107
Chicago, IL 60613-6074
Phone (708) 297-5899

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
198.000782ILMDAcupuncturist
84000096AINMDAcupuncturist
578-055WIMDAcupuncturist
578COMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1619384575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 N BROADWAY ST",
            "address_2": "107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136074",
            "telephone_number": "708-297-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 N BROADWAY ST",
            "address_2": "107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136074",
            "telephone_number": "708-297-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "PHRANQUE",
        "name_prefix": "Dr.",
        "credential": "DAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.000782",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "578-055",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "578",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IN",
            "license": "84000096A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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