Self Renewal Concepts, Inc

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP1252 Issued in FL

Legal business name

SELF RENEWAL CONCEPTS, INC

Practice address

325 S Orlando Ave
Suite 3-4
Winter Park, FL 32789-3608

Phone

(407) 375-4974

NPI assigned

Apr 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sally H Tygart, AP

Title

Ceo

Phone

(407) 375-4974

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1346636685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S ORLANDO AVE",
            "address_2": "SUITE 3-4",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893608",
            "telephone_number": "407-375-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S ORLANDO AVE",
            "address_2": "SUITE 3-4",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893608",
            "telephone_number": "407-375-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF RENEWAL CONCEPTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "TYGART",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-375-4974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AP"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.