NPIMap

Individual provider Active NPI

Brianne Racine Manninen, L.AC.

  • Acupuncturist
  • Bozeman, MT
National Provider Identifier
1972805778
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 60122573 Issued in WA
Practice address
3508 Laramie Dr Ste 3
Bozeman, MT 59718-2006
Phone
(503) 803-2017
NPI assigned
Nov 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X MED-ACU-LIC-14656 MT
Acupuncturist 171100000X AC 60122573 WA Primary

Addresses

Primary practice location

3508 Laramie Dr Ste 3
Bozeman, MT 59718-2006

Mailing address

3508 Laramie Dr Ste 3
Bozeman, MT 59718-2006
Phone (503) 803-2017

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
MED-ACU-LIC-14656MTMDAcupuncturist
AC 60122573WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Wellness PLLC PastSince May 7, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1972805778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 LARAMIE DR STE 3",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182006",
            "telephone_number": "503-803-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 LARAMIE DR STE 3",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182006",
            "telephone_number": "503-803-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNINEN",
        "first_name": "BRIANNE",
        "middle_name": "RACINE",
        "name_prefix": "Mrs.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MT",
            "license": "MED-ACU-LIC-14656",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60122573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.