Active NPI
Kristen Zachariah
- Military Health Care Provider
- Eglin Afb, FL
National Provider Identifier
1174266969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 96TH Medical Group
307 Boatner Rd
Eglin Afb, FL 32542 - Phone
- (850) 883-8600
- NPI assigned
- Apr 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
96TH Medical Group
307 Boatner Rd
Eglin Afb, FL 32542
Mailing address
96TH Medical Group
307 Boatner Rd
Eglin Afb, FL 32542
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1174266969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96TH MEDICAL GROUP",
"address_2": "307 BOATNER RD",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "32542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96TH MEDICAL GROUP",
"address_2": "307 BOATNER RD",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "32542",
"telephone_number": "850-883-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACHARIAH",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2023-09-14",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eglin Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.