Active NPI
Zachary M Kersten
- Student in an Organized Health Care Education/Training Program
- Springfield, MO
National Provider Identifier
1972067635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 634 E Bear Blvd Apt 309
Springfield, MO 65806-3821 - Phone
- (618) 980-9310
- NPI assigned
- Jan 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
634 E Bear Blvd Apt 309
Springfield, MO 65806-3821
Mailing address
634 E Bear Blvd Apt 309
Springfield, MO 65806-3821
Phone (618) 980-9310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| UNKNOWN | Other | TRICARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548633600000",
"number": "1972067635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "634 E BEAR BLVD APT 309",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658063821",
"telephone_number": "618-980-9310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 E BEAR BLVD APT 309",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658063821",
"telephone_number": "618-980-9310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSTEN",
"first_name": "ZACHARY",
"middle_name": "M",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-28",
"last_updated": "2019-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "UNKNOWN",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.