Tacarra Jernagin

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

4704340544 Issued in MI

Practice address

21509 Fenkell St
Detroit, MI 48223-1512

Phone

(734) 460-5100

NPI assigned

Dec 26, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1619746146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STEEPLECHASE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481880026",
            "telephone_number": "124-867-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21509 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482231512",
            "telephone_number": "734-460-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNAGIN",
        "first_name": "TACARRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MI",
            "license": "4704340544",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704340544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tae Ho Jeong
• Wooju Jeong, M.D.
• Dawn Lasha Jerangan
• Jerel N Owens, DMD, PC
• Jerel Owens D.M.D., P.C.
• Bridgette L Jerrels, D.P.M.
• Jerusalem Gate Ministry
• Weston Reynolds Jeshurun, DO
• Jesscaring Home Care & Support Services
• Jet Dental of Michigan PLLC

• General Practice Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.