Individual provider Active NPI

Caitlin Gordon, D.AC.

  • Acupuncturist
  • Boulder, CO
National Provider Identifier
1619388873
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
ACU.0002011 Issued in CO
Practice address
2500 30TH St Ste 205
Boulder, CO 80301-1236
Phone
(303) 997-8746
NPI assigned
May 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X ACU.0002011 CO Primary

Addresses

Primary practice location

2500 30TH St Ste 205
Boulder, CO 80301-1236

Mailing address

2500 30TH St Ste 205
Boulder, CO 80301-1236
Phone (303) 997-8746

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
ACU.0002011COMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Amaluna Wellness, LLC Acupuncturist CurrentSince Aug 29, 2021 Accepting new patients

Locations

2500 30th St
Ste 205
Boulder, CO 80301
Phone (303) 997-8746

1525 Spruce St
Ste 301
Boulder, CO 80302

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": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1619388873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 30TH ST STE 205",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011236",
            "telephone_number": "303-997-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 30TH ST STE 205",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011236",
            "telephone_number": "303-997-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CAITLIN",
        "name_prefix": "Dr.",
        "credential": "D.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "ACU.0002011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.