Individual provider Active NPI

Madelon Zegers

  • Pediatric Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1255734646
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5766 Issued in CA
Practice address
3814 Auburn Blvd
Suite 72
Sacramento, CA 95821-2123
Phone
(916) 426-1902
Fax
(916) 426-1940
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 415027 CA
Pediatric Nurse Practitioner 363LP0200X 5766 CA Primary

Addresses

Primary practice location

3814 Auburn Blvd
Suite 72
Sacramento, CA 95821-2123

Mailing address

3814 Auburn Blvd
Suite 72
Sacramento, CA 95821-2123
Phone (916) 426-1902

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

State licenses

LicenseStateTypeSpecialty
415027CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1255734646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 AUBURN BLVD",
            "address_2": "SUITE 72",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212123",
            "telephone_number": "916-426-1902",
            "fax_number": "916-426-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 AUBURN BLVD",
            "address_2": "SUITE 72",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212123",
            "telephone_number": "916-426-1902",
            "fax_number": "916-426-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEGERS",
        "first_name": "MADELON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "415027",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "5766",
            "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 Sep 30, 2014; 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.