Jesse A Warner, LAC, MSOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

985-55 Issued in WI

Practice address

107 N 3Rd St
Delavan, WI 53115-1157

Phone

(262) 475-3535

NPI assigned

Feb 14, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jesse A Beiermann Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Om Alternative Health Partners, Inc

  • Acupuncturist
  • Delavan, WI
  • NPI 1548734569
  NPD Authorized official

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1427558691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N 3RD ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151157",
            "telephone_number": "262-475-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N 3RD ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151157",
            "telephone_number": "262-475-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "JESSE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LAC, MSOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.001415",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "985-55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "198.001415",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "985-55",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "BEIERMANN",
            "middle_name": "A",
            "credential": "LAC, MSOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acupuncturist in Delavan, WI
• Providers in Delavan, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.