Individual provider Active NPI

Jennifer Roseman, L.AC.

  • Acupuncturist
  • Prescott, AZ
National Provider Identifier
1487197992
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1050 Issued in AZ
Practice address
2105 Demerse Ave
Prescott, AZ 86301-1013
Phone
(928) 713-8333
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1050 AZ Primary

Addresses

Primary practice location

2105 Demerse Ave
Prescott, AZ 86301-1013

Mailing address

2105 Demerse Ave
Prescott, AZ 86301-1013
Phone (928) 713-3833

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

Practice roles

OrganizationSpecialtyStatusNew patients
Breath of Life Acupuncture & Wellness PLLC Acupuncturist Past Accepting new patients

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": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1487197992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 DEMERSE AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011013",
            "telephone_number": "928-713-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 DEMERSE AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011013",
            "telephone_number": "928-713-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMAN",
        "first_name": "JENNIFER",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.