Jacksonville Oriental Medicine Center

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

200001915786 Issued in NC

Legal business name

JACKSONVILLE ORIENTAL MEDICINE CENTER

Practice address

99 Village Dr
Suite 16
Jacksonville, NC 28546-7067

Phone

(910) 989-0002

Fax

(910) 353-9753

NPI assigned

Jan 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Vivian Manduca-Marquez, L.AC.NPI 1225095284

Title

President

Phone

(910) 989-0002

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.

• Vivian Manduca-Marquez, A.P., D.O.M.

  • Acupuncturist
  • Jacksonville, NC
  • NPI 1225095284
  NPD (past) Authorized official

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1952452179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR",
            "address_2": "SUITE 16",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467067",
            "telephone_number": "910-989-0002",
            "fax_number": "910-353-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR",
            "address_2": "SUITE 16",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467067",
            "telephone_number": "910-989-0002",
            "fax_number": "910-353-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE ORIENTAL MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "MANDUCA-MARQUEZ",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-989-0002",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "200001915786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Acupuncturist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.