Zackary Yates

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1620 Lakeshore Preserve Cir Apt 114
Casselberry, FL 32707-2437

Phone

(703) 853-6207

NPI assigned

Apr 20, 2026

Reactivated

May 18, 2026

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

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1154265015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 LAKESHORE PRESERVE CIR APT 114",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072437",
            "telephone_number": "703-853-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 LAKESHORE PRESERVE CIR APT 114",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072437",
            "telephone_number": "703-853-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "ZACKARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-05-18",
        "certification_date": "2026-04-19",
        "deactivation_date": "2026-04-20",
        "reactivation_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Casselberry, FL
• Providers in Casselberry, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.