Jennifer Suzanne Villa, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

005978 Issued in NY

Practice address

625 Ayrault Rd
Fairport, NY 14450-3076

Phone

(585) 465-1056

NPI assigned

May 17, 2017

Last updated

May 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Suzanne Long Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1639606981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 PROVIDENCE DR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809492",
            "telephone_number": "315-730-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 AYRAULT RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503076",
            "telephone_number": "585-465-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "JENNIFER",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LONG",
            "middle_name": "SUZANNE",
            "credential": "L.AC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Marie Vaughn, M.S., R.D., C.D.N
• Erica R Vera, LMSW
• Nicholas John Vergari, PHARMD
• Bridget Viens
• Lauren Vigue
• Sophia Villani
• Ralph Saverio Viola, M.D.
• Samantha A Vitagliano, DMD
• Anna Vitale
• Corinne Wagner, SP. ED. TEACHER

• Acupuncturist in Fairport, NY
• Providers in Fairport, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.