Individual provider Active NPI

Candi Carmody

  • Acupuncturist
  • Kenosha, WI
National Provider Identifier
1831862341
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1026-55 Issued in WI
Practice address
705 50TH St
Kenosha, WI 53140-3336
Phone
(262) 977-8793
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1026-55 WI Primary

Addresses

Primary practice location

705 50TH St
Kenosha, WI 53140-3336

Mailing address

915 Park Ave
Winthrop Harbor, IL 60096-1737
Phone (847) 877-5086

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
1026-55WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1831862341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 PARK AVE",
            "city": "WINTHROP HARBOR",
            "state": "IL",
            "postal_code": "600961737",
            "telephone_number": "847-877-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 50TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403336",
            "telephone_number": "262-977-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMODY",
        "first_name": "CANDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "1026-55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.