Individual provider Active NPI

Anna Christine Jaquith, LAC, LMT

  • Acupuncturist
  • Hayward, WI
National Provider Identifier
1407489503
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1044-55 Issued in OR
Practice address
15657 County Highway B
Hayward, WI 54843-2680
Phone
(715) 798-3330
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 1044-55 OR Primary

Addresses

Primary practice location

15657 County Highway B
Hayward, WI 54843-2680

Mailing address

PO Box 494
Hayward, WI 54843-0494
Phone (715) 798-3330

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
1044-55ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Sanctuary LLC Acupuncturist CurrentSince Dec 8, 2024 Accepting new patients

Locations

15657 W County Highway B
Hayward, WI 54843
Phone (715) 634-3333

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.

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1407489503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548430494",
            "telephone_number": "715-798-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15657 COUNTY HIGHWAY B",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432680",
            "telephone_number": "715-798-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUITH",
        "first_name": "ANNA",
        "middle_name": "CHRISTINE",
        "credential": "LAC, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "1044-55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.