Ancient Fern Medicine

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC161759 Issued in OR

Legal business name

ANCIENT FERN MEDICINE

Practice address

2926 NE Flanders St Ste 2C
Portland, OR 97232-3259

Phone

(971) 227-2773

Fax

(971) 275-1961

NPI assigned

Jul 8, 2016

Last updated

Jul 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Nicholas Nelson, L.AC.NPI 1083955694

Title

Owner

Phone

(971) 227-2773

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy N Nelson, LAC.

  • Acupuncturist
  • Portland, OR
  • NPI 1083955694
  Authorized official Same address or phone
• Sarah Nelson

  • Acupuncturist
  • Portland, OR
  • NPI 1265988034
  NPD (past)

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1053763466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 NE FLANDERS ST STE 2C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323259",
            "telephone_number": "971-227-2773",
            "fax_number": "971-275-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 NE FLANDERS ST STE 2C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323259",
            "telephone_number": "971-227-2773",
            "fax_number": "971-275-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCIENT FERN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-227-2773",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC161759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500669071",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAL BOARD",
            "identifier": "AC161759",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Ancharski, REGISTERED NURSE
• Marie Ancharski, RN
• Patricia A Ancharski
• Anchor Within Counseling
• Anchored Healing Therapy LLC
• Joanna M Anctil, MSW, LCSW
• Tina Marie Anctil, PH.D., LPC
• Andaluz Birth Center (Andaluz Waterbirth Center)
• Andaluz Birth Center (Andaluz Waterbirth Center)
• Nicole K Andeen, M.D.

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; 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.