Evergreen Medical Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

EVERGREEN MEDICAL ACUPUNCTURE LLC

Practice address

30480 Stagecoach Blvd
Evergreen, CO 80439-8680

Phone

(303) 594-8348

Fax

(303) 600-7873

NPI assigned

Oct 19, 2020

Last updated

Aug 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christina Fick, DAOMNPI 1356780217

Title

Owner

Phone

(303) 594-8348

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David P Wiebe, MD

  • Emergency Medicine Physician
  • Boulder, CO
  • NPI 1053385351
  Medicare reassignment NPD
• Christina Fick, L.AC.

  • Acupuncturist
  • Evergreen, CO
  • NPI 1356780217
  NPD Authorized official

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1801495122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30480 STAGECOACH BLVD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804398680",
            "telephone_number": "303-594-8348",
            "fax_number": "303-600-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30480 STAGECOACH BLVD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804398680",
            "telephone_number": "303-594-8348",
            "fax_number": "303-600-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-594-8348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DAOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "1727",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Evergreen Physical Therapy Specialists, PC

• Acupuncturist in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Acupuncturist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.