Active NPI
Traci L Wilson, LAC
- Acupuncturist
- Sheridan, WY
National Provider Identifier
1073841664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 234
- Practice address
- 45 E Loucks St
Suite 014
Sheridan, WY 82801-6339 - Phone
- (307) 655-8055
- NPI assigned
- Nov 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 234 | MT | Primary |
Addresses
Primary practice location
45 E Loucks St
Suite 014
Sheridan, WY 82801-6339
Mailing address
45 E Loucks St
Suite 014
Sheridan, WY 82801-6339
Phone (307) 655-8055
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
| License | State | Type | Specialty |
|---|---|---|---|
| 234 | MT | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1073841664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 E LOUCKS ST",
"address_2": "SUITE 014",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828016339",
"telephone_number": "307-655-8055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 E LOUCKS ST",
"address_2": "SUITE 014",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828016339",
"telephone_number": "307-655-8055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TRACI",
"middle_name": "L",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-19",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MT",
"license": "234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.