Individual provider Active NPI

Carla J Zacher, MD

  • Pediatrics Physician
  • Bismarck, ND
National Provider Identifier
1700828225
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8228 Issued in ND
Practice address
828 Kirkwood Mall
Bismarck, ND 58504-5752
Phone
(701) 530-6000
Fax
(701) 530-6430
NPI assigned
Jun 11, 2006
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8228 ND Primary

Addresses

Primary practice location

828 Kirkwood Mall
Bismarck, ND 58504-5752

Mailing address

401 N 9TH St
Bismarck, ND 58501-4507
Phone (701) 530-6000

Other identifiers 1

IdentifierTypeStateIssuer
10944MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000625 ND Practitioner - Pediatric Medicine 8527012459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8228NDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Aug 10, 2020 Accepting new patients
Sanford Bismarck CurrentSince Aug 10, 2020 Accepting new patients
St. Alexius Heart & Lung Clinic, LLC Past Accepting new patients
Mid Dakota Clinic, Inc. Past Accepting new patients
Missouri Basin Anesthesia, PLLC Past Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

765 W Interstate Ave
Bismarck, ND 58503
Phone (701) 323-3700

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1700828225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-530-6000",
            "fax_number": "701-530-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 KIRKWOOD MALL",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045752",
            "telephone_number": "701-530-6000",
            "fax_number": "701-530-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHER",
        "first_name": "CARLA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "8228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10944",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.