Individual provider Active NPI

Rachel M Zenner, FNP

  • Family Nurse Practitioner
  • Kalkaska, MI
National Provider Identifier
1336794114
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704249124 Issued in MI
Practice address
103 W 3Rd St Unit E
Kalkaska, MI 49646-5107
Phone
(231) 620-7977
NPI assigned
Aug 7, 2019
Last updated
Aug 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704249124 MI Primary

Addresses

Primary practice location

103 W 3Rd St Unit E
Kalkaska, MI 49646-5107

Mailing address

3300 Pembrook Dr
Traverse City, MI 49685-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191214000315 MI Practitioner - Nurse Practitioner 1951734425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Skin Cancer and Dermatology Center PLCGroup PAC ID 5597012096, 5 clinicians

Practice addresses (Care Compare)

5199 N Royal Dr
Traverse City, MI 49684-9201
Phone 231486023012

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704249124MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Skin Cancer and Dermatology Center PLC CurrentSince Nov 25, 2019 Accepting new patients
Life's Work Clinic, PLLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

502 Cobb St
Cadillac, MI 49601
Phone 231486023012

1225 W Front St
Ste C
Traverse City, MI 49684
Phone (231) 486-0230

5199 N Royal Dr
Traverse City, MI 49684
Phone (231) 486-0230

1225 W Front St
#2
Traverse City, MI 49684
Phone (231) 486-0230

Interoperability endpoints

  • Direct secure messaging: rachel@vdermatology.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1336794114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 PEMBROOK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W 3RD ST UNIT E",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496465107",
            "telephone_number": "231-620-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENNER",
        "first_name": "RACHEL",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704249124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalkaska, MI

Sources for this page

Verify at the official NPI Registry.