Individual provider Active NPI

Kassandra Renee Sorokach, L. AP, DIP. OM

  • Acupuncturist
  • Bushnell, FL
National Provider Identifier
1629760640
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP4471 Issued in FL
Practice address
1135 W C 48
Bushnell, FL 33513-8971
Phone
(352) 603-0333
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP4471 FL Primary

Addresses

Primary practice location

1135 W C 48
Bushnell, FL 33513-8971

Mailing address

9479 CR 735
Webster, FL 33597-4043
Phone (352) 603-7763

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
AP4471FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Acupuncture and Wellness LLC Acupuncturist CurrentSince Feb 1, 2024 Accepting new patients

Locations

1135 W C 48
Bushnell, FL 33513
Phone (352) 603-0333

109 E Joe P Strickland Jr Ave
Bushnell, FL 33513
Phone (352) 282-0200

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1629760640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9479 CR 735",
            "city": "WEBSTER",
            "state": "FL",
            "postal_code": "335974043",
            "telephone_number": "352-603-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W C 48",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335138971",
            "telephone_number": "352-603-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOROKACH",
        "first_name": "KASSANDRA",
        "middle_name": "RENEE",
        "credential": "L. AP, DIP. OM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP4471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bushnell, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.