Adrienne Zackery, CEO, NURSE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN071269 Issued in GA

Practice address

1115 Mount Zion Rd Ste 10
Morrow, GA 30260-2241

Phone

(770) 917-2570

NPI assigned

Jan 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Purposeful Health & Lab Solutions, LLC

  • Clinic/Center
  • Morrow, GA
  • NPI 1437802188

  Licensed Practical Nurse

  NPD

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1407508344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 MOUNT ZION RD STE 10",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602241",
            "telephone_number": "770-917-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 MOUNT ZION RD STE 10",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602241",
            "telephone_number": "770-917-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKERY",
        "first_name": "ADRIENNE",
        "credential": "CEO, NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-05-23",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN071269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Donald Yancich, D.C.
• Nooshin Yazdanpanah, OD
• Tyler B Young, DPT
• Your Parent'S Place
• Your Parents Place
• Gwendolyn Kloth Zember, M.D.
• Kimberly A Zielke, M.D.

• Licensed Practical Nurse in Morrow, GA
• Providers in Morrow, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.