Alissa Marjorie Stockton, L.AC., D.O.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AZ0373 Issued in AZ

Practice address

1059 N. College Ave.
Thatcher, AZ 85552

Phone

(928) 965-9545

NPI assigned

Nov 7, 2006

Last updated

May 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Alissa Marjorie Polen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Green Mountain Wellness

  • Acupuncturist
  • Thatcher, AZ
  • NPI 1497369730
  NPD Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1871662593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 N. COLLEGE AVE.",
            "address_2": "PO BOX 1119",
            "city": "THATCHER",
            "state": "AZ",
            "postal_code": "85552",
            "telephone_number": "928-965-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 N. COLLEGE AVE.",
            "city": "THATCHER",
            "state": "AZ",
            "postal_code": "85552",
            "telephone_number": "928-965-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "ALISSA",
        "middle_name": "MARJORIE",
        "name_prefix": "Mrs.",
        "credential": "L.AC., D.O.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "0373",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "AZ0373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISSA",
            "last_name": "POLEN",
            "middle_name": "MARJORIE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Silver Skies Dermatology LLC
• Mayuree Siripoon, DNS, FNP-BC
• Alexander A Smith, DC
• Kenneth L Smith
• Jennifer Kay Sorensen, RN
• Thatcher Unified School District #4
• Katie Jane Thompson
• Eric Wane Tunell, DO
• Marianne Tysoe, PHARMD
• Brooks Christopher Udall

• Acupuncturist in Thatcher, AZ
• Providers in Thatcher, AZ by specialty
• Acupuncturist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.