Traci Ann Bredenkamp, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

2018043155 Issued in MO

Practice address

201 N Main St Ste 210
Saint Charles, MO 63301-2878

Phone

(618) 207-8869

NPI assigned

Apr 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1174085229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N MAIN ST STE 210",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAIN ST STE 210",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012878",
            "telephone_number": "618-207-8869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 Hunters Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633661472",
            "country_code": "US",
            "telephone_number": "618-207-8869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREDENKAMP",
        "first_name": "TRACI",
        "middle_name": "ANN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "MO",
            "license": "2018043155",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MO",
            "license": "2018043155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Brautigam, LCSW
• Paul Allen Brautigam, LPC, NCC
• Kelly Lynn Bray, PT
• Breakthrough Behavioral Care, LLC
• Kenley Anne Breckenridge, PLPC
• Hannah Christina Brein, DMD
• Judith Ann Breining, RPH
• Dan Brennan
• Terri L Brennan, CRNFA
• Pamela J Breshears, P.T.

• Acupuncturist in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Acupuncturist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.