Individual provider Active NPI

Stefanie Dwyer, LAC

  • Acupuncturist
  • Austin, TX
National Provider Identifier
1679013593
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01736 Issued in TX
Practice address
5424 W Highway 290
Ste 106
Austin, TX 78735-8827
Phone
(512) 387-4002
NPI assigned
Feb 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01736 TX Primary

Addresses

Primary practice location

5424 W Highway 290
Ste 106
Austin, TX 78735-8827

Mailing address

5424 W Highway 290
Ste 106
Austin, TX 78735-8827
Phone (512) 387-4002

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
AC01736TXMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Si Shou Acupuncture and Wellness, PLLC Acupuncturist CurrentSince Jul 12, 2020 Accepting new patients

Locations

5424 W Highway 290
Ste 106
Austin, TX 78735
Phone (512) 387-4002

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1679013593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 W HIGHWAY 290",
            "address_2": "STE 106",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358827",
            "telephone_number": "512-387-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 W HIGHWAY 290",
            "address_2": "STE 106",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358827",
            "telephone_number": "512-387-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "STEFANIE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.