Individual provider Active NPI

Anna Nicole Werderitsch, L.AC.

  • Acupuncturist
  • Chelsea, MI
National Provider Identifier
1043448749
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
5402000118 Issued in MI
Practice address
350 N Main St Ste 250
Chelsea, MI 48118-1486
Phone
(530) 414-6419
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 8773 CA
Acupuncturist 171100000X 5402000118 MI Primary

Addresses

Primary practice location

350 N Main St Ste 250
Chelsea, MI 48118-1486

Mailing address

11980 San Vicente Blvd
Suite 112
Los Angeles, CA 90049-5012
Phone (310) 826-3706

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
5402000118MIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1043448749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD",
            "address_2": "SUITE 112",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495012",
            "telephone_number": "310-826-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N MAIN ST STE 250",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181486",
            "telephone_number": "530-414-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERDERITSCH",
        "first_name": "ANNA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "8773",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5402000118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.