Individual provider Active NPI

Abigale Faith Jagger, DO

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1356922231
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Detroit Medical Center, Gme Office, 4201 St. Antoine
Uhc-9C
Detroit, MI 48201-4820
Phone
(313) 745-1892
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Detroit Medical Center, Gme Office, 4201 St. Antoine
Uhc-9C
Detroit, MI 48201-4820

Mailing address

10560 Heimberger Rd NW
Baltimore, OH 43105-9405
Phone (614) 306-8807

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Cerner

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)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1356922231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10560 HEIMBERGER RD NW",
            "city": "BALTIMORE",
            "state": "OH",
            "postal_code": "431059405",
            "telephone_number": "614-306-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DETROIT MEDICAL CENTER, GME OFFICE, 4201 ST. ANTOINE",
            "address_2": "UHC-9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482014820",
            "telephone_number": "313-745-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGER",
        "first_name": "ABIGALE",
        "middle_name": "FAITH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cerner",
            "affiliation": "N",
            "address_1": "Detroit Medical Center, GME office, 4201 St. Antoine",
            "address_2": "UHC-9C",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482014820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.