Individual provider Active NPI

Paul Messersmith-Glavin, L.AC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1285000513
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00889 Issued in OR
Practice address
1428 SE 19TH Ave Ste G
Portland, OR 97214-4516
Phone
(503) 868-9889
NPI assigned
Aug 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00889 OR Primary

Addresses

Primary practice location

1428 SE 19TH Ave Ste G
Portland, OR 97214-4516

Mailing address

1428 SE 19TH Ave Ste G
Portland, OR 97214-4516
Phone (503) 886-9889

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
AC00889ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
3 Dragons Acupuncture and Herbs Acupuncturist CurrentSince Mar 12, 2023 Accepting new patients
National University of Natural Medicine Past Accepting new patients
Acupuncture Center of Portland East LLC Acupuncturist PastSince Apr 28, 2024 Accepting new patients

Locations

1428 SE 19th Ave
Ste G
Portland, OR 97214
Phone (503) 347-1048

Organizations & group practices 3

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": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1285000513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 SE 19TH AVE STE G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144516",
            "telephone_number": "503-886-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 SE 19TH AVE STE G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144516",
            "telephone_number": "503-868-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSERSMITH-GLAVIN",
        "first_name": "PAUL",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.