Individual provider Active NPI

Elisabeth Nichole Dreyer, L.AC.

  • Acupuncturist
  • Park City, UT
National Provider Identifier
1720364771
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
10358219-1201 Issued in UT
Practice address
5532 Lillehammer LN Ste 102
Park City, UT 84098-6078
Phone
(970) 618-4788
NPI assigned
Oct 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1625 CO
Acupuncturist 171100000X 10358219-1201 UT Primary

Addresses

Primary practice location

5532 Lillehammer LN Ste 102
Park City, UT 84098-6078

Mailing address

5532 Lillehammer LN Ste 102
Park City, UT 84098-6078
Phone (970) 618-4788

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
10358219-1201UTMDAcupuncturist
1625COMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1720364771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5532 LILLEHAMMER LN STE 102",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986078",
            "telephone_number": "970-618-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5532 LILLEHAMMER LN STE 102",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986078",
            "telephone_number": "970-618-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYER",
        "first_name": "ELISABETH",
        "middle_name": "NICHOLE",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "1625",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "UT",
            "license": "10358219-1201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.