Individual provider Active NPI

Veronika Tynes, DIP. O.M., LAC, MSOM

  • Acupuncturist
  • Lake Mary, FL
National Provider Identifier
1295287704
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
3778 Issued in FL
Practice address
450 Saint Charles CT
Lake Mary, FL 32746-2176
Phone
(727) 776-9949
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 3778 FL Primary

Addresses

Primary practice location

450 Saint Charles CT
Lake Mary, FL 32746-2176

Mailing address

5005 Gardens Dr
Orlando, FL 32812-8782

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3778FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Vivid Recovery LLC Acupuncturist CurrentSince Apr 9, 2021 Accepting new patients

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1295287704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 GARDENS DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328128782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SAINT CHARLES CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462176",
            "telephone_number": "727-776-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNES",
        "first_name": "VERONIKA",
        "credential": "DIP. O.M., LAC, MSOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "3778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.