Individual provider Active NPI

Mamie Burruss, ND, LAC

  • Acupuncturist
  • Little Rock, AR
National Provider Identifier
1396189189
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
089 Issued in AR
Practice address
425 W Capitol Ave Ste 1242
Little Rock, AR 72201-3405
Phone
(888) 376-2643
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 099.0134038 VT
Acupuncturist 171100000X 089 AR Primary

Addresses

Primary practice location

425 W Capitol Ave Ste 1242
Little Rock, AR 72201-3405

Mailing address

425 W Capitol Ave Ste 1242
Little Rock, AR 72201-3405
Phone (888) 376-2643

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
089ARMDAcupuncturist
099.0134038VTMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1396189189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W CAPITOL AVE STE 1242",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722013405",
            "telephone_number": "888-376-2643",
            "fax_number": "888-376-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W CAPITOL AVE STE 1242",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722013405",
            "telephone_number": "888-376-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUSS",
        "first_name": "MAMIE",
        "name_prefix": "Dr.",
        "credential": "ND, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2023-02-25",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "VT",
            "license": "099.0134038",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AR",
            "license": "089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; 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.