Individual provider Active NPI

Maureen Nelis, L.AC.BOARD CERTIFIED

  • Acupuncturist
  • Columbia, MD
National Provider Identifier
1366771826
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
UO1281 Issued in MD
Practice address
9170 Route 108 Ste 202
Columbia, MD 21045-1988
Phone
(410) 740-0080
Fax
(410) 730-1172
NPI assigned
Dec 12, 2009
Last updated
Sep 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X UO1281 MD Primary

Addresses

Primary practice location

9170 Route 108 Ste 202
Columbia, MD 21045-1988

Mailing address

5517 Mystic CT
Columbia, MD 21044-1856
Phone (410) 740-0080

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
UO1281MDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1260576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1366771826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5517 MYSTIC CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441856",
            "telephone_number": "410-740-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9170 ROUTE 108 STE 202",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451988",
            "telephone_number": "410-740-0080",
            "fax_number": "410-730-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELIS",
        "first_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "L.AC.BOARD CERTIFIED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-12",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "UO1281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.