Individual provider Active NPI

Ramon Gutierrez, A.P.

  • Acupuncturist
  • Port Orange, FL
National Provider Identifier
1043416712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP2096 Issued in FL
Practice address
4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170
Phone
(386) 898-0908
Fax
(386) 898-0242
NPI assigned
Jun 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP2096 FL Primary

Addresses

Primary practice location

4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170

Mailing address

4904 S Clyde Morris Blvd
Ste D2
Port Orange, FL 32129-4170
Phone (386) 898-0908

Other identifiers 5

IdentifierTypeStateIssuer
Y923DOtherFLBCBS FACILITY # OC
Y926BOtherFLBCBS FACILITY # OB
1720155997OtherFLGROUP NPI
C2977OtherFLBCBS ACU # RAMON
Y923LOtherFLBCBS FACILITY # PO

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

LicenseStateTypeSpecialty
AP2096FLMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043416712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 S CLYDE MORRIS BLVD",
            "address_2": "STE D2",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294170",
            "telephone_number": "386-898-0908",
            "fax_number": "386-898-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 S CLYDE MORRIS BLVD",
            "address_2": "STE D2",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294170",
            "telephone_number": "386-898-0908",
            "fax_number": "386-898-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "RAMON",
        "credential": "A.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP2096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY # OC",
            "identifier": "Y923D",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY # OB",
            "identifier": "Y926B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1720155997",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ACU # RAMON",
            "identifier": "C2977",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY # PO",
            "identifier": "Y923L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.