Individual provider Active NPI

Jacqueline Deborah Barry, LIC.AC

  • Acupuncturist
  • Columbia, MD
National Provider Identifier
1619215308
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U02025 Issued in MD
Practice address
10705 Charter Dr Ste 420
Columbia, MD 21044-2800
Phone
(443) 820-8253
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U02025 MD Primary

Addresses

Primary practice location

10705 Charter Dr Ste 420
Columbia, MD 21044-2800

Mailing address

11474 Iager Blvd
Fulton, MD 20759-2507
Phone (443) 820-8253

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
U02025MDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1619215308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11474 IAGER BLVD",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592507",
            "telephone_number": "443-820-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 CHARTER DR STE 420",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442800",
            "telephone_number": "443-820-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "JACQUELINE",
        "middle_name": "DEBORAH",
        "name_prefix": "Ms.",
        "credential": "LIC.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.