Individual provider Active NPI

Shan Kong

  • Acupuncturist
  • Ann Arbor, MI
National Provider Identifier
1699094078
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
171-055 Issued in WI
Practice address
4343 Concourse Dr Ste 110
Ann Arbor, MI 48108-8400
Phone
(734) 996-0888
NPI assigned
May 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 171-055 WI Primary

Addresses

Primary practice location

4343 Concourse Dr Ste 110
Ann Arbor, MI 48108-8400

Mailing address

4343 Concourse Dr Ste 110
Ann Arbor, MI 48108-8400
Phone (734) 996-0888

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
171-055WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1699094078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 CONCOURSE DR STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088400",
            "telephone_number": "734-996-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 CONCOURSE DR STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088400",
            "telephone_number": "734-996-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "SHAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "171-055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.