Energy Base LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

ENERGY BASE LLC

Doing business as

Sage Chi Integrative Wellness

Practice address

1629 Crofton Ctr Ste 18
Crofton, MD 21114-1318

Phone

(301) 580-4585

Fax

(240) 366-5954

NPI assigned

Apr 12, 2021

Last updated

Sep 28, 2021By 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. Tiaa C. Hartley, D.AC, L.ACNPI 1770139511

Title

Owner

Phone

(301) 580-4585

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sage Chi Integrative Wellness Doing business as

Locations

Practitioners 1

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.

• Tiaa C. Hartley, D.AC, L.AC

  • Acupuncturist
  • Crofton, MD
  • NPI 1770139511
  NPD Authorized official

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1912587239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 STATE ROUTE 3 N STE 282",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "301-580-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 CROFTON CTR STE 18",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141318",
            "telephone_number": "301-580-4585",
            "fax_number": "240-366-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGY BASE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "TIAA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-580-4585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.AC, L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764013700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sage Chi Integrative Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Shadrea Myquis Fallon

• Acupuncturist in Crofton, MD
• Providers in Crofton, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.