Individual provider Active NPI

Diane Susan Wintzer, LAC, EAMP

  • Acupuncturist
  • Camas, WA
National Provider Identifier
1104062074
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC60055845 Issued in WA
Practice address
430 NE Cedar St
Camas, WA 98607-2144
Phone
(360) 851-4268
Fax
(844) 244-8288
NPI assigned
Dec 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC60055845 WA Primary
Acupuncturist 171100000X AC01249 OR

Addresses

Primary practice location

430 NE Cedar St
Camas, WA 98607-2144

Mailing address

430 NE Cedar St
Camas, WA 98607-2144
Phone (360) 851-4268

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
AC01249ORMDAcupuncturist
AC60055845WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Wintzer Acupuncture LLC Acupuncturist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1104062074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NE CEDAR ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072144",
            "telephone_number": "360-851-4268",
            "fax_number": "844-244-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NE CEDAR ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072144",
            "telephone_number": "360-851-4268",
            "fax_number": "844-244-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTZER",
        "first_name": "DIANE",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "credential": "LAC, EAMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60055845",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.