Ingrid Kerry Diaz Reyes, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC02142 Issued in TX

Practice address

151 Kirkham Cir
Kyle, TX 78640-9703

Phone

(512) 893-3376

NPI assigned

Jul 19, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• SJC Medical Group LLC

  • Clinic/Center
  • Kyle, TX
  • NPI 1174230866
  NPD (past)

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1669210811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 HAZELNUT CT",
            "city": "DRIFTWOOD",
            "state": "TX",
            "postal_code": "786194489",
            "telephone_number": "716-361-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KIRKHAM CIR",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786409703",
            "telephone_number": "512-893-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ REYES",
        "first_name": "INGRID",
        "middle_name": "KERRY",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC02142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malia Deshay
• Devries Family Chiropractic, P.a.
• Eric Thomas Devries, D.C.
• Wendy Ann Devries, D.C.
• Maheshkumar Dholariya, D.D.S.
• Gustavo Diaz-Reyes, MD
• Alexis Diaz
• Robert Benjamin Dickinson, MD
• Kindra Nichole Dietrich, DMD
• Tatiana Alexandra Dillon

• Acupuncturist in Kyle, TX
• Providers in Kyle, TX by specialty
• Acupuncturist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.