Active NPI
Sandra Zakroff, M.D.
- Family Medicine Physician
- Jackson, MO
National Provider Identifier
1821072976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2001004451
- Practice address
- 545 Broadridge Dr
Jackson, MO 63755-3001 - Phone
- (573) 243-8408
- Fax
- (573) 243-0445
- NPI assigned
- Dec 2, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2001004451 | MO | Primary |
Addresses
Primary practice location
545 Broadridge Dr
Jackson, MO 63755-3001
Mailing address
PO Box 843225
Kansas City, MO 64184-3225
Phone (708) 633-1234
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050010581 | Other | MO | CPIN |
| 1821072976 | Other | MO | ANTHEM BCBS |
| 1821072976 | Medicaid | MO | |
| 205286909 | Medicaid | MO | |
| 466716 | Other | MO | HEALTHLINK |
| 205286917 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001004451 | MO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1821072976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843225",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843225",
"telephone_number": "708-633-1234",
"fax_number": "708-342-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 BROADRIDGE DR",
"city": "JACKSON",
"state": "MO",
"postal_code": "637553001",
"telephone_number": "573-243-8408",
"fax_number": "573-243-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAKROFF",
"first_name": "SANDRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-02",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2001004451",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CPIN",
"identifier": "050010581",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "1821072976",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821072976",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205286909",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "466716",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205286917",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.