Organization Active NPI

Rising Tide Natural Medicine

  • Acupuncturist
  • Boulder, CO
National Provider Identifier
1104157858
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1127 Issued in CO
Legal business name
RISING TIDE NATURAL MEDICINE
Practice address
2321 30TH St
Boulder, CO 80301-1103
Phone
(303) 501-0819
NPI assigned
Jan 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Dr. Liam McClintock, ND, LAC
Title
President
Phone
(207) 865-1222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 1127 CO Primary
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X NP227 ME
HomeopathGroup: 193200000X MULTI-SPECIALTY GROUP 175L00000X

Addresses

Primary practice location

2321 30TH St
Boulder, CO 80301-1103

Mailing address

4985 Twin Lakes Rd
Apt 87
Boulder, CO 80301-3894
Phone (303) 501-0819

Other names 1

  • RTNM Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1104157858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 TWIN LAKES RD",
            "address_2": "APT 87",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013894",
            "telephone_number": "303-501-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 30TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011103",
            "telephone_number": "303-501-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING TIDE NATURAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "MCCLINTOCK",
        "authorized_official_first_name": "LIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-865-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND, LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "1127",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "ME",
            "license": "NP227",
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homeopath",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RTNM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.