Individual provider Active NPI

Madelyn Jean Zeigler, CNP

  • Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1366410896
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704128374 Issued in MI
Practice address
217 S Madison Street
Traverse City, MI 49684-2320
Phone
(231) 392-8400
Fax
(231) 935-7888
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704128374 MI Primary

Addresses

Primary practice location

217 S Madison Street
Traverse City, MI 49684-2320

Mailing address

2513 Momentum PL
Chicago, IL 60689-6325
Phone (231) 935-6080

Other identifiers 2

IdentifierTypeStateIssuer
4151578MedicaidMI
5008762580OtherMIBCBS OF MICHIGAN

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
Certified Nurse Practitioner, Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1366410896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606896325",
            "telephone_number": "231-935-6080",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MADISON STREET",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842320",
            "telephone_number": "231-392-8400",
            "fax_number": "231-935-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEIGLER",
        "first_name": "MADELYN",
        "middle_name": "JEAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704128374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4151578",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "5008762580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.