Peng Roden Her, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1588 Issued in MN

Practice address

5603 Chicago Ave
Minneapolis, MN 55417-2429

Phone

(612) 708-0753

NPI assigned

Sep 28, 2012

Sex

Male

Sole proprietor

No

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

Practice roles

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.

• Formless Form Qigong & Acupuncture

  • Acupuncturist
  • Minneapolis, MN
  • NPI 1306199864
  NPD (past) Authorized official

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1760733885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4357 30TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063710",
            "telephone_number": "612-708-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172429",
            "telephone_number": "612-708-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HER",
        "first_name": "PENG",
        "middle_name": "RODEN",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-28",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kee Her-Yang, PA
• Andy Her
• Erica P Her, CGC
• Ia Ong Her, OD
• Mina Her
• Yu Peng Her
• Zoua Her
• Grace-Anne Marie Herard, P.T.
• Debra Ann Herbaugh, CNS, APRN
• Mikaela B. Herberg, MD

• Acupuncturist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.