Individual provider Active NPI

Takeisha Latrice Zeigler, REGISTERED NURSE

  • Administrator Registered Nurse
  • Saint Clair Shores, MI
National Provider Identifier
1609155480
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
4704317210 Issued in MI
Practice address
22525 E 8 Mile Rd
Saint Clair Shores, MI 48080-2433
Phone
(754) 207-5634
NPI assigned
Aug 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 5188499 FL
Administrator Registered Nurse 163WA2000X 4704317210 MI Primary

Addresses

Primary practice location

22525 E 8 Mile Rd
Saint Clair Shores, MI 48080-2433

Mailing address

22525 E 8 Mile Rd
Saint Clair Shores, MI 48080-2433
Phone (754) 207-5634

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

State licenses

LicenseStateTypeSpecialty
4704317210MIMDAdministrator Registered Nurse
5188499FLMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Cook Center CurrentSince Jul 9, 2021 Accepting new patients
Ann Cook Dialysis Center Current Accepting new patients
Ann Cook Dialysis Center, LLC CurrentSince Sep 27, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1609155480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22525 E 8 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802433",
            "telephone_number": "754-207-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22525 E 8 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802433",
            "telephone_number": "754-207-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEIGLER",
        "first_name": "TAKEISHA",
        "middle_name": "LATRICE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "5188499",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MI",
            "license": "4704317210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.