Individual provider Active NPI

Rachel Jaffe Wilson

  • Acupuncturist
  • Peachtree City, GA
National Provider Identifier
1376073577
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
401 Issued in GA
Practice address
609 Garamond PL
Peachtree City, GA 30269-2606
Phone
(770) 365-0487
Fax
(770) 365-0487
NPI assigned
Jun 20, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 401 GA Primary

Addresses

Primary practice location

609 Garamond PL
Peachtree City, GA 30269-2606

Mailing address

301 Raintree BND
Peachtree City, GA 30269-2228
Phone (770) 365-0487

Other practice location 1

301 Raintree Bnd
Peachtree City, GA 30269-2228
Phone (770) 365-0487

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
401GAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376073577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RAINTREE BND",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692228",
            "telephone_number": "770-365-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 GARAMOND PL",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302692606",
            "telephone_number": "770-365-0487",
            "fax_number": "770-365-0487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Raintree Bnd",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302692228",
            "country_code": "US",
            "telephone_number": "770-365-0487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RACHEL",
        "middle_name": "JAFFE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.