Individual provider Active NPI

Michael Wayne Gandy, LAC

  • Acupuncturist
  • Grants Pass, OR
National Provider Identifier
1710640677
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00566 Issued in OR
Practice address
6155 Tunnel Loop Rd
Grants Pass, OR 97526-8743
Phone
(541) 535-4325
NPI assigned
Oct 18, 2021
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 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 AC00566 OR Primary

Addresses

Primary practice location

6155 Tunnel Loop Rd
Grants Pass, OR 97526-8743

Mailing address

6155 Tunnel Loop Rd
Grants Pass, OR 97526-8743
Phone (541) 535-4325

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
AC00566ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1710640677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6155 TUNNEL LOOP RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975268743",
            "telephone_number": "541-535-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 TUNNEL LOOP RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975268743",
            "telephone_number": "541-535-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDY",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.