Individual provider Active NPI

Melissa S Bichanich, L.AC

  • Acupuncturist
  • Oconomowoc, WI
National Provider Identifier
1114360658
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
788-55 Issued in WI
Practice address
361 Yosemite Rd
Oconomowoc, WI 53066-2292
Phone
(262) 995-8778
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 788-55 WI Primary

Addresses

Primary practice location

361 Yosemite Rd
Oconomowoc, WI 53066-2292

Mailing address

126 E Wisconsin Ave Ste 102
Oconomowoc, WI 53066-3034
Phone (262) 995-8778

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
788-55WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1114360658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E WISCONSIN AVE STE 102",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663034",
            "telephone_number": "262-995-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 YOSEMITE RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530662292",
            "telephone_number": "262-995-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICHANICH",
        "first_name": "MELISSA",
        "middle_name": "S",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "788-55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.