Jennifer Leigh Takach, DNP, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R220912 Issued in MD

Practice address

11161 New Hampshire Ave Ste 301
Silver Spring, MD 20904-2606

Phone

(301) 681-7101

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1205319373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 OAKVALE ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208532131",
            "telephone_number": "301-502-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 NEW HAMPSHIRE AVE STE 301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042606",
            "telephone_number": "301-681-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKACH",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DNP, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R220912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samuel Tabe Taku
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• Pediatric Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.