Maureen Ann McNulty, L.AC., LMT, DIPL OM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

660-055 Issued in WI

Practice address

148 East State Street
Suite a
Burlington, WI 53105

Phone

(773) 677-8458

Fax

(262) 995-1422

NPI assigned

Apr 18, 2013

Last updated

Jul 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1043654288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST STATE STREET",
            "address_2": "SUITE A",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "53105",
            "telephone_number": "773-677-8458",
            "fax_number": "262-995-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST STATE STREET",
            "address_2": "SUITE A",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "53105",
            "telephone_number": "773-677-8458",
            "fax_number": "262-995-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "MAUREEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.AC., LMT, DIPL OM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "660-055",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "5060-146",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE INSURANCE COMPANY",
            "identifier": "817175493",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan R Mathews, MD
• Steven D. Mayo, M.D.
• Emily McClory, NP
• Thomas Bernard McCormack Jr., RPH
• Jon W. McKinney, OD
• Medix Ambulance Services, Inc
• Michelle Marie Mehring, LPN
• Alan Dean Meike, DC
• Marnie Meisner
• Lina Melcher, NP-C

• Acupuncturist in Burlington, WI
• Providers in Burlington, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.