Denise Carol Tyson, DOM, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

U01974 Issued in MD

Practice address

2401 Brandermill Blvd
Ste 301
Gambrills, MD 21054-1604

Phone

(410) 774-0800

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

• Advanced Integrative Health Group

  • Acupuncturist
  • Gambrills, MD
  • NPI 1720445158
  NPD Authorized official

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1447617873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD",
            "address_2": "STE 301",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541604",
            "telephone_number": "410-774-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD",
            "address_2": "STE 301",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541604",
            "telephone_number": "410-774-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "DENISE",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DOM, L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U01974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.