Individual provider Active NPI

Roger Bayer, DACM

  • Acupuncturist
  • Virginia Beach, VA
National Provider Identifier
1265115661
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
0121001125 Issued in VA
Practice address
1492 S Independence Blvd Ste 102
Virginia Beach, VA 23462-5252
Phone
(757) 431-0053
NPI assigned
Aug 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 4158 FL
Acupuncturist 171100000X 0121001125 VA Primary

Addresses

Primary practice location

1492 S Independence Blvd Ste 102
Virginia Beach, VA 23462-5252

Mailing address

9189 Fontainebleau Blvd Unit 13
Miami, FL 33172-6311
Phone (305) 753-9815

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
4158FLMDAcupuncturist
0121001125VAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Illumination, LLC Acupuncturist CurrentSince Mar 20, 2025 Accepting new patients

Locations

1492 S Independence Blvd
Ste 102
Virginia Beach, VA 23462
Phone (757) 431-0053

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1265115661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9189 FONTAINEBLEAU BLVD UNIT 13",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331726311",
            "telephone_number": "305-753-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 S INDEPENDENCE BLVD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625252",
            "telephone_number": "757-431-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYER",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "DACM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "4158",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121001125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.