Individual provider Active NPI

Rachael Lynn Breinling Tax, LAC

  • Acupuncturist
  • Rockford, MI
National Provider Identifier
1912683558
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
5402000196 Issued in MI
Practice address
4655 14 Mile Rd NE Ste B
Rockford, MI 49341-7308
Phone
(616) 884-0645
NPI assigned
Jun 27, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Acupuncturist 171100000X 5402000196 MI Primary

Addresses

Primary practice location

4655 14 Mile Rd NE Ste B
Rockford, MI 49341-7308

Mailing address

4655 14 Mile Rd NE Ste B
Rockford, MI 49341-7308
Phone (616) 884-0645

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
5402000196MIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1912683558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 14 MILE RD NE STE B",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493417308",
            "telephone_number": "616-884-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 14 MILE RD NE STE B",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493417308",
            "telephone_number": "616-884-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAX",
        "first_name": "RACHAEL",
        "middle_name": "LYNN BREINLING",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5402000196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.