Kiyoshi Yamamoto, LAC., LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

0121000947 Issued in VA

Practice address

1033 Sterling Rd Ste 105
Herndon, VA 20170-3837

Phone

(703) 855-3514

NPI assigned

Dec 7, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• A&C Clinical Manipulation, LLC

  • Acupuncturist
  • Herndon, VA
  • NPI 1275201774
  NPD Authorized official

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1730482159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 CASTLE HARBOR WAY",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201204140",
            "telephone_number": "703-855-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 STERLING RD STE 105",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703837",
            "telephone_number": "703-855-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "KIYOSHI",
        "credential": "LAC., LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "19003726",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Herndon, VA
• Acupuncturist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.