Eagle Peak Wellness, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EAGLE PEAK WELLNESS, INC.

Doing business as

Eagle Peak Acupuncture

Practice address

394 Hasbrouck Ave # 2C
Kingston, NY 12401-4631

Phone

(845) 750-4896

NPI assigned

Aug 18, 2021

Last updated

Aug 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacquelyn Rose Riddick, LAC, LMTNPI 1184043572

Title

President

Phone

(845) 750-4896

Specialties & licenses 1

Addresses

Other names 1

• Eagle Peak Acupuncture Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacquelyn R Riddick, LAC.

  • Acupuncturist
  • Kingston, NY
  • NPI 1184043572
  NPD Authorized official

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1396411690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 HASBROUCK AVE # 2C",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014631",
            "telephone_number": "845-750-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 HASBROUCK AVE # 2C",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014631",
            "telephone_number": "845-750-4896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "New Paltz",
            "state": "NY",
            "postal_code": "125611552",
            "country_code": "US",
            "telephone_number": "845-750-4896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAGLE PEAK WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "RIDDICK",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-750-4896",
        "authorized_official_credential": "LAC, LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jriddick@acubillers.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "394 Hasbrouck Ave # 2C",
            "city": "Kingston",
            "state": "NY",
            "country_code": "US",
            "postal_code": "124014631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eagle Peak Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eagle Peak Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colman Potter Durkee, LCSW
• Anastasia Duval-Yonnetti, MA, EDM, LMHC
• Linda Duval
• Kate Maria Dvorkin, PSYD
• Sarah Dzimian
• Reginald J Earls
• Eckerd Corporation (Rite Aid Pharmacy 10700)
• Alicia Nicole Ector
• Sahja Ector
• Jessica Edelman, LMT

• Clinic/Center in Kingston, NY
• Providers in Kingston, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.