Individual provider Active NPI

Shengyan Grace Tan, LAC

  • Acupuncturist
  • Austin, TX
National Provider Identifier
1902150808
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Practice address
2700 W Anderson LN Ste 512
Austin, TX 78757-1359
Phone
(512) 467-0370
Fax
(512) 454-8846
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X Primary

Addresses

Primary practice location

2700 W Anderson LN Ste 512
Austin, TX 78757-1359

Mailing address

2700 W Anderson LN Ste 512
Austin, TX 78757-1359
Phone (512) 467-0370

Other names 1

  • Grace Tan Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace & Young Acupuncture PLLC Acupuncturist CurrentSince Mar 29, 2020 Accepting new patients
Aoma Academy LLP Acupuncturist Past Accepting new patients
Michael R. Bandy DC Past Accepting new patients

Locations

12411 Hymeadow Dr
Ste 3D
Austin, TX 78750
Phone (512) 609-8095

Organizations & group practices 3

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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1902150808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W ANDERSON LN STE 512",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571359",
            "telephone_number": "512-467-0370",
            "fax_number": "512-454-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W ANDERSON LN STE 512",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571359",
            "telephone_number": "512-467-0370",
            "fax_number": "512-454-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SHENGYAN",
        "middle_name": "GRACE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "TAN",
            "credential": "LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.