Individual provider Active NPI

Bethany Richardson, L.AC.

  • Acupuncturist
  • San Antonio, TX
National Provider Identifier
1053482729
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC8377 Issued in CA
Practice address
4207 Gardendale St Ste B103
San Antonio, TX 78229-3182
Phone
(210) 999-5579
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC8377 CA Primary

Addresses

Primary practice location

4207 Gardendale St Ste B103
San Antonio, TX 78229-3182

Mailing address

4207 Gardendale St Ste B103
San Antonio, TX 78229-3182
Phone (210) 999-5579

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
AC8377CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Enliven Health and Wellness Acupuncturist CurrentSince Jul 31, 2022 Accepting new patients

Locations

4207 Gardendale St
Ste B103
San Antonio, TX 78229
Phone (210) 999-5579

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1053482729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 GARDENDALE ST STE B103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293182",
            "telephone_number": "210-999-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 GARDENDALE ST STE B103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293182",
            "telephone_number": "210-999-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BETHANY",
        "name_prefix": "Mrs.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC8377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.