Individual provider Active NPI

Owen Bryn Marron, L.AC

  • Acupuncturist
  • Roseville, CA
National Provider Identifier
1093762163
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 14630 Issued in CA
Practice address
151 N Sunrise Ave
Suite #1009
Roseville, CA 95661-2930
Phone
(916) 742-4001
Fax
(916) 474-5322
NPI assigned
May 27, 2006
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 14630 CA Primary

Addresses

Primary practice location

151 N Sunrise Ave
Suite #1009
Roseville, CA 95661-2930

Mailing address

151 N Sunrise Ave
Suite #1009
Roseville, CA 95661-2924
Phone (916) 742-4001

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
AC 14630CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture Medical Center, a Professional Corporation Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1093762163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "SUITE #1009",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-742-4001",
            "fax_number": "916-474-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "SUITE #1009",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612930",
            "telephone_number": "916-742-4001",
            "fax_number": "916-474-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRON",
        "first_name": "OWEN",
        "middle_name": "BRYN",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 14630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.