Michael Gary Ricci, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC200078 Issued in OR

Practice address

11750 SW Barnes Rd Ste 240
Portland, OR 97225-5911

Phone

(503) 389-6962

NPI assigned

Nov 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Advanced Wellness Center

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1275921660
  NPD (past)

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

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1942800560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144008",
            "telephone_number": "503-407-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SW BARNES RD STE 240",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255911",
            "telephone_number": "503-389-6962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 SE 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972144008",
            "country_code": "US",
            "telephone_number": "503-407-7062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICCI",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-01",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC200078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Scott Ribner, PSY.D.
• Adriana Ricardo Diaz, CHW
• Heather Marie Ricart
• Louis P. Riccelli, MD
• Brian C Ricci, M.D.
• Jessica Anne Rice-Rodgers, LCSW
• Travis L Rice-Stitt, MD
• Alexandra Marie Rice
• Anderson Rice
• Caitlin Margaret Rice, PT

• Acupuncturist in Portland, OR
• Providers in Portland, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; 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.