Individual provider Active NPI

Kolin Durrant, DACM, L.AC.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1891453593
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Practice address
4501 Mission Bay Dr Ste 2D
San Diego, CA 92109-4925
Phone
(858) 333-7907
NPI assigned
Nov 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 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 Primary

Addresses

Primary practice location

4501 Mission Bay Dr Ste 2D
San Diego, CA 92109-4925

Mailing address

1443 Golden Gate Dr
San Diego, CA 92116-1138
Phone (619) 550-6461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kolin@manifesthw.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Manifest Health & Wellness Acupuncture, Inc. Acupuncturist CurrentSince Dec 5, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1891453593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 GOLDEN GATE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161138",
            "telephone_number": "619-550-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MISSION BAY DR STE 2D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094925",
            "telephone_number": "858-333-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRANT",
        "first_name": "KOLIN",
        "name_prefix": "Dr.",
        "credential": "DACM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kolin@manifesthw.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4501 Mission Bay Dr Ste 2D",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921094925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.