Individual provider Active NPI

Brandon Lagreca, CAC

  • Acupuncturist
  • East Troy, WI
National Provider Identifier
1720125867
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
555-055 Issued in WI
Practice address
3278 Main St
East Troy, WI 53120-1152
Phone
(262) 642-4325
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 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 555-055 WI Primary

Addresses

Primary practice location

3278 Main St
East Troy, WI 53120-1152

Mailing address

PO Box 885
East Troy, WI 53120-0885

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
555-055WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1720125867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 885",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531200885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3278 MAIN ST",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531201152",
            "telephone_number": "262-642-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRECA",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "CAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "555-055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Troy, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.