Active NPI
Tymothy Smith, LAC
- Acupuncturist
- Arcata, CA
National Provider Identifier
1023678901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 12064
- Practice address
- 920 Samoa Blvd Ste 222
Arcata, CA 95521-6696 - Phone
- (707) 616-2086
- NPI assigned
- Jun 13, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 12064 | CA | Primary |
Addresses
Primary practice location
920 Samoa Blvd Ste 222
Arcata, CA 95521-6696
Mailing address
PO Box 769
Redway, CA 95560-0769
Phone (707) 923-2783
Other practice location 1
101 West Coast Rd.
Redway, CA 95560-9556
Phone (707) 923-2783
Other practice location 2
2620 Central Ave
McKinleyville, CA 95519-3619
Phone (707) 630-5222
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redwoods Rural Health Center Inc. | Acupuncturist | Past | Accepting new patients |
| Redwoods Rural Health Center Inc. | Past | Accepting new patients |
Interoperability endpoints
- timothy.smith.p1@direct.rrhc.nextgenshare.com
Organizations & group practices 2
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.
-
- Community Health Clinic/Center
- Redway, CA
- NPI 1235206087
-
- Acupuncturist
- McKinleyville, CA
- NPI 1467008748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1023678901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 769",
"city": "REDWAY",
"state": "CA",
"postal_code": "955600769",
"telephone_number": "707-923-2783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 SAMOA BLVD STE 222",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216696",
"telephone_number": "707-616-2086"
}
],
"practiceLocations": [
{
"address_1": "101 West Coast Rd.",
"address_purpose": "LOCATION",
"city": "Redway",
"state": "CA",
"postal_code": "955609556",
"country_code": "US",
"telephone_number": "707-923-2783",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2620 Central Ave",
"address_purpose": "LOCATION",
"city": "McKinleyville",
"state": "CA",
"postal_code": "955193619",
"country_code": "US",
"telephone_number": "707-630-5222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "TYMOTHY",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "12064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.