Active NPI
Gudrun Jackson, L.AC.
- Acupuncturist
- Athens, OH
National Provider Identifier
1568225688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 65.000441
- Practice address
- 1005 E State St Ste E
Athens, OH 45701-2151 - Phone
- (740) 677-9872
- NPI assigned
- Feb 1, 2024
- Last updated
- Feb 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 65.000441 | OH | Primary |
Addresses
Primary practice location
1005 E State St Ste E
Athens, OH 45701-2151
Mailing address
7597 N Coolville Ridge Rd
Athens, OH 45701-9432
Phone (614) 208-3141
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
| License | State | Type | Specialty |
|---|---|---|---|
| 65.000441 | OH | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1568225688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7597 N COOLVILLE RIDGE RD",
"city": "ATHENS",
"state": "OH",
"postal_code": "457019432",
"telephone_number": "614-208-3141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 E STATE ST STE E",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012151",
"telephone_number": "740-677-9872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "GUDRUN",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-01",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OH",
"license": "65.000441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.