Individual provider Active NPI

Jennifer Diane Weiss, JENNIFER WEISS, LAC

  • Acupuncturist
  • Fairfield, CT
National Provider Identifier
1083881072
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
000446 Issued in NY
Practice address
130 Fairchild Ave
305
Fairfield, CT 06825-4848
Phone
(914) 804-2864
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 000446 NY Primary
Acupuncturist 171100000X 105 CT

Addresses

Primary practice location

130 Fairchild Ave
305
Fairfield, CT 06825-4848

Mailing address

130 Fairchild Ave
305
Fairfield, CT 06825

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
105CTMDAcupuncturist
000446NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1083881072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FAIRCHILD AVE",
            "address_2": "305",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FAIRCHILD AVE",
            "address_2": "305",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254848",
            "telephone_number": "914-804-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "credential": "JENNIFER WEISS, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "000446",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CT",
            "license": "105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.