Individual provider Active NPI

William R. Underwood Jr., L. AC.

  • Acupuncturist
  • Longmont, CO
National Provider Identifier
1861892986
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
0002020 Issued in CO
Practice address
1551 Professional LN
Suite 180
Longmont, CO 80501-6972
Phone
(303) 772-0598
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0002020 CO Primary

Addresses

Primary practice location

1551 Professional LN
Suite 180
Longmont, CO 80501-6972

Mailing address

1225 Ken Pratt Blvd
Unit 120
Longmont, CO 80501
Phone (303) 772-0598

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
0002020COMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Eye Care Center of the Rockies, LLC Acupuncturist CurrentSince Feb 12, 2023 Accepting new patients
Good Life Acupuncture & Wellness Center PastSince Apr 1, 2021 Accepting new patients

Locations

1225 Ken Pratt Blvd
Unit 120
Longmont, CO 80501
Phone (720) 513-1233

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1861892986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 KEN PRATT BLVD",
            "address_2": "UNIT 120",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-0598",
            "fax_number": "720-302-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN",
            "address_2": "SUITE 180",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016972",
            "telephone_number": "303-772-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L. AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "0002020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.