Zackary Steven Lloyd Ladson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-007283 Issued in IL

Practice address

3248 Vandever Ave Ste B
Pekin, IL 61554-6277

Phone

(309) 680-7600

Fax

(309) 495-8698

NPI assigned

Oct 3, 2019

Sex

Male

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: zackary.ladson.p48@direct.medcor.nextgenshare.com

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1457992158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-680-7669",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 VANDEVER AVE STE B",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546277",
            "telephone_number": "309-680-7600",
            "fax_number": "309-495-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADSON",
        "first_name": "ZACKARY",
        "middle_name": "STEVEN LLOYD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-007283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Jeffrey Krug, MD
• Debra S Kruzan
• David S. Kuban, D.D.S.
• Patricia Ann Kutyna, MSW, LCSW
• Kyle'S Home Care Services
• Austin Lair
• Timothy Michael Lamb, MA LCPC
• Jaclyn Rene Lamer, CPNP-AC, PMHNP-BC
• Alicia J Langley, LSW, CADC
• Danielle Marianna Larson, RDN, LD

• All providers in Pekin, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.