Individual provider Active NPI

Josephine Chan, DOM, AP

  • Acupuncturist
  • Orlando, FL
National Provider Identifier
1982143665
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
3797 Issued in FL
Practice address
924 N Magnolia Ave Ste 332
Orlando, FL 32803-3852
Phone
(407) 758-0179
Fax
(407) 602-0942
NPI assigned
Feb 15, 2017
Reactivated
Feb 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 3797 FL Primary

Addresses

Primary practice location

924 N Magnolia Ave Ste 332
Orlando, FL 32803-3852

Mailing address

1937 Corner Glen Dr
Orlando, FL 32820-1952
Phone (407) 758-0179

Other identifiers 1

IdentifierTypeStateIssuer
107565300MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3797FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Natural Medical Center LLC Acupuncturist CurrentSince Oct 9, 2020 Accepting new patients

Locations

3101 Maguire Blvd
Ste 230
Orlando, FL 32803

924 N Magnolia Ave
Ste 332
Orlando, FL 32803
Phone (407) 758-0179

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1982143665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 CORNER GLEN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328201952",
            "telephone_number": "407-758-0179",
            "fax_number": "407-602-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 N MAGNOLIA AVE STE 332",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033852",
            "telephone_number": "407-758-0179",
            "fax_number": "407-602-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JOSEPHINE",
        "credential": "DOM, AP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "deactivation_date": "2021-01-12",
        "reactivation_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "3797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107565300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.