Active NPI
Michael Wiadro, L.AC
- Acupuncturist
- Breckenridge, CO
National Provider Identifier
1285162123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 2579
- Practice address
- 424 S Ridge St
Ste 3
Breckenridge, CO 80424 - Phone
- (610) 389-8422
- NPI assigned
- May 23, 2017
- Last updated
- May 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | U02108 | MD | |
| Acupuncturist | 171100000X | 2579 | CO | Primary |
Addresses
Primary practice location
424 S Ridge St
Ste 3
Breckenridge, CO 80424
Mailing address
862 Shekel LN
Breckenridge, CO 80424-8958
Phone (610) 389-8422
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2579 | CO | MD | Acupuncturist |
| U02108 | MD | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1285162123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "862 SHEKEL LN",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "804248958",
"telephone_number": "610-389-8422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 S RIDGE ST",
"address_2": "STE 3",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "80424",
"telephone_number": "610-389-8422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIADRO",
"first_name": "MICHAEL",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-23",
"last_updated": "2023-05-24",
"certification_date": "2023-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MD",
"license": "U02108",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CO",
"license": "2579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, CO
- Vail Summit Physical Therapy LLC (Avalanche Physical Therapy)
- Vail-Summit Orthopaedics PC (Avalanche Physical Thearpy)
- Vail-Summit Orthopaedics PC (Vail Summit Physical Therapy)
- John Greer Warner, D.D.S.
- Justin Michael Welch, PT, DPT
- Larry Gale Willhite, M.D.
- Alaina Carol Wischmeyer, DC
- Tori Kristine Woodward, DPT
- Your Family Medical Home,PLLC
- Michael Yura, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.