Individual provider Active NPI

Deeann Briggs Tak, BSN-RN, CDCES

  • Diabetes Educator Registered Nurse
  • Idaho Falls, ID
National Provider Identifier
1821715095
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
N-32403 Issued in ID
Practice address
3200 Channing Way Ste 102
Idaho Falls, ID 83404-7546
Phone
(208) 528-2925
Fax
(208) 528-7371
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X N-32403 ID Primary

Addresses

Primary practice location

3200 Channing Way Ste 102
Idaho Falls, ID 83404-7546

Mailing address

3200 Channing Way Ste 102
Idaho Falls, ID 83404-7546
Phone (208) 528-2925

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

LicenseStateTypeSpecialty
N-32403IDMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1821715095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 102",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-528-2925",
            "fax_number": "208-528-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 102",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-528-2925",
            "fax_number": "208-528-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "DEEANN",
        "middle_name": "BRIGGS",
        "credential": "BSN-RN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "ID",
            "license": "N-32403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.