Individual provider Active NPI

Nelly Tkach

  • Community Health Worker
  • Sacramento, CA
National Provider Identifier
1255100665
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
6615 Valley Hi Dr
Sacramento, CA 95823-7076
Phone
(916) 450-2650
NPI assigned
Dec 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

6615 Valley Hi Dr
Sacramento, CA 95823-7076

Mailing address

6615 Valley Hi Dr
Sacramento, CA 95823-7076
Phone (916) 450-2600

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1255100665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 VALLEY HI DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958237076",
            "telephone_number": "916-450-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 VALLEY HI DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958237076",
            "telephone_number": "916-450-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACH",
        "first_name": "NELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.

Verify at the official NPI Registry.