Kimiko Shimoda, DIPL. OM, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

2167 Issued in NC

Practice address

18809 W Catawba Ave Ste 204
Cornelius, NC 28031-5895

Phone

(704) 912-4691

NPI assigned

Dec 4, 2023

Sex

Female

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

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1659147304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18809 W CATAWBA AVE STE 204",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315895",
            "telephone_number": "704-912-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18809 W CATAWBA AVE STE 204",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315895",
            "telephone_number": "704-912-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMODA",
        "first_name": "KIMIKO",
        "credential": "DIPL. OM, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "2167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Sharp, MS, RD, CDCES
• Jacqueline Shelter
• Kenadie Sherman
• Scott Alan Sherman, RPH
• Pamela Passarelli Sherrill, RD
• Shine & Grow Pediatric Therapy PLLC
• William Bradley Shook, D.C.
• Kirkwood Tanner Shultz, MD
• Inga R Siler, MS, CCC-SLP
• Thea Oculato Silva de Souza, PH.D.

• Acupuncturist in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Acupuncturist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.