Individual provider Active NPI

Ann Marie Fitzgerald, L.AC, MSTOM, MPH

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1134339062
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
11511 Issued in CA
Practice address
1224 Pennsylvania Ave Apt 1
San Diego, CA 92103-4428
Phone
(619) 293-3578
NPI assigned
May 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 11511 CA Primary

Addresses

Primary practice location

1224 Pennsylvania Ave Apt 1
San Diego, CA 92103-4428

Mailing address

1224 Pennsylvania Ave Apt 1
San Diego, CA 92103-4428
Phone (619) 293-3578

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
11511CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134339062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 PENNSYLVANIA AVE APT 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034428",
            "telephone_number": "619-293-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 PENNSYLVANIA AVE APT 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034428",
            "telephone_number": "619-293-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "L.AC, MSTOM, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.