Active NPI
Angie Zdrazil
- Psychiatric/Mental Health Registered Nurse
- Fort Dodge, IA
National Provider Identifier
1730874389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 104777
- Practice address
- 1307 Knollcrest Dr
Fort Dodge, IA 50501-2921 - Phone
- (515) 571-1555
- NPI assigned
- Apr 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 104777 | IA | Primary |
Addresses
Primary practice location
1307 Knollcrest Dr
Fort Dodge, IA 50501-2921
Mailing address
530 S 25TH Street
Fort Dodge, IA 50501
Phone (515) 574-5985
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
| License | State | Type | Specialty |
|---|---|---|---|
| 104777 | IA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1730874389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 S 25TH STREET",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "50501",
"telephone_number": "515-574-5985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 KNOLLCREST DR",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505012921",
"telephone_number": "515-571-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZDRAZIL",
"first_name": "ANGIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "IA",
"license": "104777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.