Active NPI
Jannah Holley Vise, L. AC
- Acupuncturist
- Canyon Lake, TX
National Provider Identifier
1104301902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC01654
- Practice address
- 190 Crazy Horse Trail
Canyon Lake, TX 78133 - Phone
- (512) 569-9178
- NPI assigned
- Sep 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01654 | TX | Primary |
Addresses
Primary practice location
190 Crazy Horse Trail
Canyon Lake, TX 78133
Mailing address
1308 Common St Ste 205
New Braunfels, TX 78130-3561
Phone (512) 569-9178
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC01654 | TX | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1104301902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 COMMON ST STE 205",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781303561",
"telephone_number": "512-569-9178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 CRAZY HORSE TRAIL",
"city": "CANYON LAKE",
"state": "TX",
"postal_code": "78133",
"telephone_number": "512-569-9178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISE",
"first_name": "JANNAH",
"middle_name": "HOLLEY",
"credential": "L. AC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-27",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "TX",
"license": "AC01654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon Lake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.