NPIMap

Organization Active NPI

Radiant Natural Health Clinic SC

  • Acupuncturist
  • Niagara, WI
National Provider Identifier
1740708262
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
652-55 Issued in WI
Legal business name
RADIANT NATURAL HEALTH CLINIC SC
Practice address
619 Washington Ave
Niagara, WI 54151
Phone
(715) 251-3555
Fax
(715) 251-3559
NPI assigned
Sep 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Authorized official

Name
Mrs. Kerry Niebrzydowski, ND LAC
Title
Owner
Phone
(715) 251-3555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 652-55 WI Primary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 857-55 WI

Addresses

Primary practice location

619 Washington Ave
Niagara, WI 54151

Mailing address

PO Box 243
Niagara, WI 54151
Phone (715) 251-3555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504569600000",
    "number": "1740708262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243",
            "city": "NIAGARA",
            "state": "WI",
            "postal_code": "54151",
            "telephone_number": "715-251-3555",
            "fax_number": "715-251-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 WASHINGTON AVE",
            "city": "NIAGARA",
            "state": "WI",
            "postal_code": "54151",
            "telephone_number": "715-251-3555",
            "fax_number": "715-251-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT NATURAL HEALTH CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A",
        "authorized_official_last_name": "NIEBRZYDOWSKI",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-251-3555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ND LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "652-55",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "857-55",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.