Individual provider Active NPI

Jeri L Zukoski, C.N.M.

  • Midwife
  • Berkeley, CA
National Provider Identifier
1386785541
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
626 Issued in CA
Practice address
2107 Dwight Way
Suite 102
Berkeley, CA 94704-2028
Phone
(510) 530-3374
NPI assigned
Feb 9, 2007
Last updated
Dec 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 626 CA Primary

Addresses

Primary practice location

2107 Dwight Way
Suite 102
Berkeley, CA 94704-2028

Mailing address

4354 Leach Ave
Oakland, CA 94602-1336
Phone (510) 530-3374

Other identifiers 1

IdentifierTypeStateIssuer
NMW006260MedicaidCA

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
626CAMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1386785541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4354 LEACH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021336",
            "telephone_number": "510-530-3374",
            "fax_number": "510-649-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DWIGHT WAY",
            "address_2": "SUITE 102",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042028",
            "telephone_number": "510-530-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUKOSKI",
        "first_name": "JERI",
        "middle_name": "L",
        "credential": "C.N.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NMW006260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.