Individual provider Active NPI

Alanna Ekua Nzoma, M.D.

  • Pediatrics Physician
  • Brighton, MI
National Provider Identifier
1730346495
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301103014 Issued in MI
Practice address
8001 Challis Road
Brighton, MI 48116
Phone
(810) 227-9510
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.125415 IL
Pediatrics Physician 208000000X 4301103014 MI Primary

Addresses

Primary practice location

8001 Challis Road
Brighton, MI 48116

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other names 1

  • Dr. Alanna E Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171023000050 MI Practitioner - Pediatric Medicine 2567738412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.125415ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Oct 10, 2017 Accepting new patients
Regents of the University of Michigan Pediatrics CurrentSince Oct 10, 2017 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

Interoperability endpoints

  • Direct secure messaging: anzoma716268@direct.med.umich.edu

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1730346495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 CHALLIS ROAD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-227-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NZOMA",
        "first_name": "ALANNA",
        "middle_name": "EKUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.125415",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301103014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALANNA",
            "last_name": "JACKSON",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.