Individual provider Active NPI

Brittany Petrick, L.AC, MSOM

  • Acupuncturist
  • Flagstaff, AZ
National Provider Identifier
1669904470
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1065 Issued in AZ
Practice address
1926 N 3Rd St Ste 100
Flagstaff, AZ 86004-4332
Phone
(928) 856-0656
Fax
(928) 404-1353
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 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 1065 AZ Primary

Addresses

Primary practice location

1926 N 3Rd St Ste 100
Flagstaff, AZ 86004-4332

Mailing address

1926 N 3Rd St Ste 100
Flagstaff, AZ 86004-4332
Phone (928) 856-0656

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1065AZMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Harmonizing Healthcare, PLLC Acupuncturist CurrentSince Aug 1, 2021 Accepting new patients

Locations

1926 N 3rd St
Ste 100
Flagstaff, AZ 86004
Phone (928) 856-0656

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1669904470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 N 3RD ST STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860044332",
            "telephone_number": "928-856-0656",
            "fax_number": "928-404-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 N 3RD ST STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860044332",
            "telephone_number": "928-856-0656",
            "fax_number": "928-404-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "BRITTANY",
        "credential": "L.AC, MSOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "1065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.