Individual provider Active NPI

Tara Crishann Nikzi, MAC. OM.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1639351067
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01146 Issued in OR
Practice address
2505 SW Spring Garden St Ste 100
Portland, OR 97219-3966
Phone
(503) 841-6222
Fax
(503) 841-6199
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 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 AC01146 OR Primary

Addresses

Primary practice location

2505 SW Spring Garden St Ste 100
Portland, OR 97219-3966

Mailing address

2505 SW Spring Garden St Ste 100
Portland, OR 97219-3966
Phone (503) 841-6222

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
AC01146ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapia P.C. 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": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1639351067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SW SPRING GARDEN ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193966",
            "telephone_number": "503-841-6222",
            "fax_number": "503-841-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SW SPRING GARDEN ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193966",
            "telephone_number": "503-841-6222",
            "fax_number": "503-841-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKZI",
        "first_name": "TARA",
        "middle_name": "CRISHANN",
        "name_prefix": "Ms.",
        "credential": "MAC. OM.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.