Active NPI
Denise Edmiston, L.AC.
- Acupuncturist
- Coppell, TX
National Provider Identifier
1386971810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC01118
- Practice address
- 413 W Bethel Rd
Suite 202
Coppell, TX 75019-4473 - Phone
- (972) 506-8113
- Fax
- (214) 432-0684
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01118 | TX | Primary |
Addresses
Primary practice location
413 W Bethel Rd
Suite 202
Coppell, TX 75019-4473
Mailing address
116 Dickens Dr
Coppell, TX 75019-2104
Phone (512) 586-1738
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 |
|---|---|---|---|
| AC01118 | TX | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Traditional Holistic Wellness,LLC | Acupuncturist | Past | 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.
-
- Acupuncturist
- Coppell, TX
- NPI 1700113230
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282694400000",
"number": "1386971810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 DICKENS DR",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192104",
"telephone_number": "512-586-1738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 W BETHEL RD",
"address_2": "SUITE 202",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194473",
"telephone_number": "972-506-8113",
"fax_number": "214-432-0684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMISTON",
"first_name": "DENISE",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-04",
"last_updated": "2010-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "TX",
"license": "AC01118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.