Active NPI
Mary Wallis, L.AC.
- Acupuncturist
- Florissant, MO
National Provider Identifier
1760830822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 2007002923
- Practice address
- 895 Rue Saint Francois
Florissant, MO 63031-4923 - Phone
- (314) 921-3366
- NPI assigned
- May 31, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 2007002923 | MO | Primary |
Addresses
Primary practice location
895 Rue Saint Francois
Florissant, MO 63031-4923
Mailing address
895 Rue Saint Francois
Florissant, MO 63031-4923
Phone (314) 921-3366
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 |
|---|---|---|---|
| 2007002923 | MO | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1760830822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 RUE SAINT FRANCOIS",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630314923",
"telephone_number": "314-921-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 RUE SAINT FRANCOIS",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630314923",
"telephone_number": "314-921-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIS",
"first_name": "MARY",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MO",
"license": "2007002923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.