Full Well Acupuncture LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1072 Issued in NM

Legal business name

FULL WELL ACUPUNCTURE LLC

Practice address

838 Columbia St
Santa Fe, NM 87505-3965

Phone

(505) 690-8048

NPI assigned

Apr 1, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Gregg Flax, DOM

Title

Owner

Phone

(505) 690-8048

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1962820456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 COLUMBIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053965",
            "telephone_number": "505-690-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 COLUMBIA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053965",
            "telephone_number": "505-690-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL WELL ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "GREGG FLAX",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-690-8048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.