Active NPI
Deeann Briggs Tak, BSN-RN, CDCES
- Diabetes Educator Registered Nurse
- Idaho Falls, ID
National Provider Identifier
1821715095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- N-32403
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| N-32403 | ID | MD | Diabetes 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.