Whitney Wickstrom Jacks, DAOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

Practice address

1528 US Highway 395 N Ste 230
Gardnerville, NV 89410-5226

Phone

(775) 783-4930

NPI assigned

Sep 26, 2023

Sex

Female

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

Practice roles

Locations

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.

• Mountain Sports Acupuncture LLC

  • Acupuncturist
  • Gardnerville, NV
  • NPI 1720869829
  NPD

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1952180218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 LARSSON ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666734",
            "telephone_number": "310-955-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 US HIGHWAY 395 N STE 230",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105226",
            "telephone_number": "775-783-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "WHITNEY",
        "middle_name": "WICKSTROM",
        "credential": "DAOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert James Houchin, DDS
• Belinda Elaine Hubkey
• Brenda J. Hulphers, LCSW
• Luke Iglinski
• Inspired Senior Living of Carson Valley Mt, LLC
• Sara Frances Jacobsen, M.S., CCC-SLP
• James J Lynch MD LTD
• Josephine James
• Brady M Jens, RPH
• Jennifer Jones

• Acupuncturist in Gardnerville, NV
• Providers in Gardnerville, NV by specialty
• Acupuncturist in Nevada

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