Fountain of Youth Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

FOUNTAIN OF YOUTH ACUPUNCTURE LLC

Practice address

1474 SC-160
Suite 103
Fort Mill, SC 29715

Phone

(201) 741-6802

NPI assigned

Sep 7, 2022

Organization subpart

No

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

Authorized official

Name

Michelina KrausNPI 1962950345

Title

Owner

Phone

(201) 741-6802

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michelina Kraus, L.AC.

  • Acupuncturist
  • Saddle Brook, NJ
  • NPI 1962950345
  NPD Authorized official

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1932820925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 GENNETT CIR APT 209",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156243",
            "telephone_number": "201-741-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1474 SC-160",
            "address_2": "SUITE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29715",
            "telephone_number": "201-741-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF YOUTH ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "KRAUS",
        "authorized_official_first_name": "MICHELINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-741-6802"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Mill School District #4
• Fort Mill Smiles Dentistry, PC
• Fort Mill Spine and Sports Rehab, LLC
• Foundation Health Systems LLC
• Foundation Health Systems LLC
• Kristie N Fountain, M.S. CCC-SLP
• Nicole Marie Fournet Koverman
• Tawana Fowler, RBT
• Kristina R Franklin, LPC, LMFT
• William Dale Franks Jr., MD

• Acupuncturist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Acupuncturist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.