NPIMap

Organization Active NPI

Mountain View Acupuncture, LLC

  • Acupuncturist
  • Bend, OR
National Provider Identifier
1093257057
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00855 Issued in OR
Legal business name
MOUNTAIN VIEW ACUPUNCTURE, LLC
Practice address
2195 NW Shevlin Park Rd
Suite 150
Bend, OR 97703-7102
Phone
(541) 388-0675
Fax
(541) 388-0685
NPI assigned
Nov 8, 2016
Last updated
Nov 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
Randa Marjon Faivre, L.AC.
Title
Owner
Phone
(541) 388-0675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00855 OR Primary

Addresses

Primary practice location

2195 NW Shevlin Park Rd
Suite 150
Bend, OR 97703-7102

Mailing address

2195 NW Shevlin Park Rd
Suite 150
Bend, OR 97703-7102
Phone (541) 388-0675

Other identifiers 4

IdentifierTypeStateIssuer
1972660603OtherORNPPES
1013073238OtherORNPPES
1306395892OtherORNPPES
1538538822OtherORNPPES

National Provider Directory

National Provider Directory

Locations

2195 NW Shevlin Park Rd
Ste 150
Bend, OR 97703
Phone (541) 388-0675

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1093257057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 NW SHEVLIN PARK RD",
            "address_2": "SUITE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037102",
            "telephone_number": "541-388-0675",
            "fax_number": "541-388-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 NW SHEVLIN PARK RD",
            "address_2": "SUITE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037102",
            "telephone_number": "541-388-0675",
            "fax_number": "541-388-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW ACUPUNCTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "FAIVRE",
        "authorized_official_first_name": "RANDA",
        "authorized_official_middle_name": "MARJON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-388-0675",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1972660603",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1013073238",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1306395892",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1538538822",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

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