Stacie Shain, D.O.M
Individual provider Active NPI Acupuncturist · Bosque Farms, NM
NPI 1124488770 · NPPES record last updated Feb 17, 2026
Key facts
- NPI
- 1124488770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 1176 (NM)
- Practice address
- 590 Bosque Farms Blvd
Bosque Farms, NM 87068-9645 - Phone
- (505) 730-1570
- NPI assigned
- Feb 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1176 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden West Acupuncture and Wellness LLC. | Acupuncturist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist |
171100000X | 1176 | NM | Yes |
Addresses
Primary practice location
590 Bosque Farms Blvd
Bosque Farms, NM 87068-9645
Mailing address
PO Box 122
Tome, NM 87060-0122
Phone (505) 730-1570
Other providers in Bosque Farms, NM
- Ettore Pittore
- Michelle Randall
- Kelly Robinson
- Korah Makayla Roybal
- Myles Sandoval
- Matthew Smith
- Southwest Medical Clinic Inc
- Martha Brown Swinney
- Teekees Clinic
- Michelle Kathryn Williams-Gabaldon
All providers in Bosque Farms, NM · Acupuncturist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.