Individual provider Active NPI

Gage Andreoli-Holmquist, DAOM

  • Acupuncturist
  • Providence, RI
National Provider Identifier
1104588185
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
DAOM00084 Issued in RI
Practice address
245 Waterman St Ste 303
Providence, RI 02906-5215
Phone
(401) 388-0881
Fax
(401) 249-4968
NPI assigned
Oct 7, 2021
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X DAOM00084 RI Primary

Addresses

Primary practice location

245 Waterman St Ste 303
Providence, RI 02906-5215

Mailing address

18 Maxson St
Ashaway, RI 02804-1604
Phone (401) 744-9847

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DAOM00084RIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Focal Acupuncture PC Acupuncturist CurrentSince Jul 9, 2023 Accepting new patients

Locations

245 Waterman St
Ste 303
Providence, RI 02906
Phone (401) 388-0881

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1104588185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MAXSON ST",
            "city": "ASHAWAY",
            "state": "RI",
            "postal_code": "028041604",
            "telephone_number": "401-744-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 WATERMAN ST STE 303",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065215",
            "telephone_number": "401-388-0881",
            "fax_number": "401-249-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREOLI-HOLMQUIST",
        "first_name": "GAGE",
        "credential": "DAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "RI",
            "license": "DAOM00084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.