Individual provider Active NPI

R Scott Nanamura, LAC

  • Acupuncturist
  • S Lake Tahoe, CA
National Provider Identifier
1609056662
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC5974 Issued in CA
Practice address
2489 Lake Tahoe Blvd
Suite 28
S Lake Tahoe, CA 96150-7728
Phone
(530) 541-6392
NPI assigned
Nov 7, 2007
Last updated
Nov 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC5974 CA Primary

Addresses

Primary practice location

2489 Lake Tahoe Blvd
Suite 28
S Lake Tahoe, CA 96150-7728

Mailing address

PO Box 9579
S Lake Tahoe, CA 96158-2579
Phone (530) 541-6392

Other identifiers 1

IdentifierTypeStateIssuer
AC5974OtherCACALIFORNIA LAC LICENSE

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
AC5974CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
R Scott Nanamura Ac Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1609056662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9579",
            "city": "S LAKE TAHOE",
            "state": "CA",
            "postal_code": "961582579",
            "telephone_number": "530-541-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 LAKE TAHOE BLVD",
            "address_2": "SUITE 28",
            "city": "S LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507728",
            "telephone_number": "530-541-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANAMURA",
        "first_name": "R",
        "middle_name": "SCOTT",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC5974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LAC LICENSE",
            "identifier": "AC5974",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in S Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.