Active NPI
Carol Ann Mersereau, DIPL. AC.
- Acupuncturist
- Jackson, WY
National Provider Identifier
1205056934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- Practice address
- 280 East Broadway
Suite 806
Jackson, WY 83001 - Phone
- (307) 733-0507
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | Primary |
Addresses
Primary practice location
280 East Broadway
Suite 806
Jackson, WY 83001
Mailing address
PO Box 331
Moose, WY 83012-0331
Phone (307) 733-0507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002874 | Other | NCCAOM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205056934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 331",
"city": "MOOSE",
"state": "WY",
"postal_code": "830120331",
"telephone_number": "307-733-0507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 EAST BROADWAY",
"address_2": "SUITE 806",
"city": "JACKSON",
"state": "WY",
"postal_code": "83001",
"telephone_number": "307-733-0507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERSEREAU",
"first_name": "CAROL",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "DIPL. AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCAOM",
"identifier": "002874",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
- Babette Epple Melka, PHARMD
- Kimberly Ann Mellick, MSN, FNP-BC
- Camille Stephanie Mellijor-Figg, M.D.
- Mental Health & Recovery Services of Jackson Hole
- Mental Health & Recovery Services of Jackson Hole (Curran-Seeley Foundation)
- Therese Lowe Metherell, RD
- Marian L Meyers, PT
- Kimberly Michele Micheletti, PT, DPT
- Heidi E Michelsen Jost, MD
- Miller Oral Surgery PC
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.