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Deactivated NPI 1710497045 Deactivated / Inactive NPI Female Practitioner

Vimolroj Osathanugrah , LAC, OMD

Acupuncturist • Henderson, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Vimolroj Osathanugrah has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 29, 2017
NPI Deactivation Date January 16, 2025
Total Practice Duration ~8 Years of Practice (2017 – 2025)

Professional Overview & Biography Verified Profile Summary

Vimolroj Osathanugrah, LAC, OMD was a registered Acupuncturist practicing in Henderson, NV. Throughout an active medical career spanning 8 years, Vimolroj Osathanugrah provided care at the practice location at 2611 NANTUCKET AVE until profile deactivation on 2025-01-16.

Practice Location & Contact Primary Location

Practice Address

2611 Nantucket Ave

Henderson, NV 890741927

Specialty Benchmarks & Practice Insights

Comparative analytics for Acupuncturist in Henderson, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
15 Specialists

Practicing in Henderson, NV (113 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Acupuncturist Primary Specialty

NUCC Taxonomy Code: 171100000X

State License CA 12713

An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated January 16, 2025

Record deactivated on January 16, 2025

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Acupuncturist (License #12713 in CA)

NPI Profile Active September 29, 2017

NPI status registered as active in NPPES database

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Updated Practice Location September 29, 2017

Registered at 2611 NANTUCKET AVE, HENDERSON, NV 890741927 (Tel: (213) 344-7255)

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Updated Business Mailing Address September 29, 2017

Registered at 2611 NANTUCKET AVE, HENDERSON, NV 890741927 (Tel: 2133447255)

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Provider Name / Credentials Updated September 29, 2017

Recorded as VIMOLROJ OSATHANUGRAH, L.AC, OMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 29, 2017

Acupuncturist (License #12713 in CA)

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Initial NPI Registration & Enumeration September 29, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710497045
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 29, 2017
Last Update: September 29, 2017
Deactivation Date: January 16, 2025

Mailing Address

2611 Nantucket Ave

Henderson, NV 890741927

Phone: 2133447255

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.