Jacqueline Lois Zortman

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

495957 Issued in MN

Practice address

40520 Cty. Hwy. 34
Ogema, MN 56569

Phone

(218) 983-4300

Fax

(218) 983-6217

NPI assigned

May 14, 2018

Sex

Female

Sole proprietor

No

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1780174979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 CTY. HWY. 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 CTY. HWY. 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "56569",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZORTMAN",
        "first_name": "JACQUELINE",
        "middle_name": "LOIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471B0102X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": "MN",
            "license": "495957",
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Mammography",
            "state": "MN",
            "license": "495957",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MN",
            "license": "495957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Ann Woodard, DDS
• Brian Douglas Wooton, DO
• Janice M Yliniemi, RT
• Hong Suk Yoon, DPM
• Darryl Robert Zitzow, PHD

• Radiologic Technologist in Ogema, MN
• Providers in Ogema, MN by specialty
• Radiologic Technologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.