Mountain Sports Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

MOUNTAIN SPORTS ACUPUNCTURE LLC

Practice address

1528 US Highway 395 N Ste 230
Gardnerville, NV 89410-5226

Phone

(775) 783-4930

Fax

(877) 731-1939

NPI assigned

Oct 13, 2023

Organization subpart

No

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

Authorized official

Name

Dr. David Wayne Edge, LAC, OMDNPI 1891874996

Title

Owner

Phone

(775) 783-4930

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Wayne Edge, L.AC., O.M.D.

  • Acupuncturist
  • Gardnerville, NV
  • NPI 1891874996
  NPD Authorized official
• Whitney Wickstrom Jacks, DAOM

  • Acupuncturist
  • Gardnerville, NV
  • NPI 1952180218
  NPD

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1720869829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 US HIGHWAY 395 N STE 230",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105226",
            "telephone_number": "775-783-4930",
            "fax_number": "877-731-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 US HIGHWAY 395 N STE 230",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105226",
            "telephone_number": "775-783-4930",
            "fax_number": "877-731-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SPORTS ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-783-4930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LAC, OMD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Gardnerville, NV
• Providers in Gardnerville, NV by specialty
• Acupuncturist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.