Active NPI
Travis Young, LAC
- Acupuncturist
- Menomonie, WI
National Provider Identifier
1710364062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 776-55
- Practice address
- 2321 Stout Rd
Menomonie, WI 54751-7003 - Phone
- (715) 233-7739
- NPI assigned
- May 6, 2015
- Last updated
- May 6, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 776-55 | WI | Primary |
Addresses
Primary practice location
2321 Stout Rd
Menomonie, WI 54751-7003
Mailing address
504 11TH St E
Menomonie, WI 54751-1938
Phone (715) 556-4189
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
| License | State | Type | Specialty |
|---|---|---|---|
| 776-55 | WI | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430870400000",
"number": "1710364062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 11TH ST E",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547511938",
"telephone_number": "715-556-4189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2321 STOUT RD",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547517003",
"telephone_number": "715-233-7739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "TRAVIS",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-06",
"last_updated": "2015-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "776-55",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.