Active NPI
Kenneth Oconnor III, DOM
- Acupuncturist
- Venice, FL
National Provider Identifier
1982269437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 4051
- Practice address
- 1511 Tamiami TRL S Ste 202
Venice, FL 34285-5578 - Phone
- (941) 228-4688
- NPI assigned
- May 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 4051 | FL | Primary |
Addresses
Primary practice location
1511 Tamiami TRL S Ste 202
Venice, FL 34285-5578
Mailing address
19027 Red Bird LN
Lithia, FL 33547-1815
Phone (617) 584-1816
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4051 | FL | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Body Acupuncture LLC | Acupuncturist | Past | 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.
-
- Acupuncturist
- Venice, FL
- NPI 1497371389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1982269437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19027 RED BIRD LN",
"city": "LITHIA",
"state": "FL",
"postal_code": "335471815",
"telephone_number": "617-584-1816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 TAMIAMI TRL S STE 202",
"city": "VENICE",
"state": "FL",
"postal_code": "342855578",
"telephone_number": "941-228-4688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OCONNOR",
"first_name": "KENNETH",
"name_suffix": "III",
"credential": "DOM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "4051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.