ZACKERY J TEGGE (NPI# 1366974123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366974123 |
| Entity Type | Individual |
| Full Name | ZACKERY J TEGGE |
| Credential | MCMS, PA-C |
| Practice Address |
4007 Estate Diamond Ruby Christiansted VI 00820 |
| Mailing Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 3407786311 |
| Mailing Telephone | 9204909046 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4320 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100077680 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4007 Estate Diamond Ruby, Christiansted, VI 008204435 | 3407786311 | |
| 5000 Memorial Dr, Two Rivers, WI 542413900 | 9207945125 | |
| 2845 Greenbrier Rd, Green Bay, WI 543116519 | 9202884060 |
| Street Address |
4007 ESTATE DIAMOND RUBY |
| City | CHRISTIANSTED |
| State | VI |
| Zip Code | 00820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295737047 | D'michelle P Dupre | Pathology | 4007 Estate Diamond Ruby, Gov. Juan F. Luis Hospital, Christiansted, VI 00820 | 2005-08-11 |
| 1346876323 | Brittany Grace Victoria Dawson | Advanced Practice Midwife | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2020-03-21 |
| 1336652999 | Jane Bruno | Advanced Practice Midwife | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2017-11-06 |
| 1093170037 | Lindsey Lee Jacobson | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2015-12-17 |
| 1750788626 | Debra Allen | Nurse Practitioner | 4007 Estate Diamond Ruby, Christiansted, VI 00821 | 2014-11-20 |
| 1447669239 | Superior Medical Dme & Supplies LLC | Durable Medical Equipment & Medical Supplies | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2014-08-06 |
| 1346582152 | Professional Component Inc | Radiology | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2013-03-19 |
| 1326315532 | John Salo | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2011-11-17 |
| 1902190572 | Keith Louis Moore | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2011-06-01 |
| 1376870261 | Amie Francisca Noelise Bannis | Advanced Practice Midwife | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2009-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619575610 | Family Medicine Associates & Consultants, Pllc | Family Medicine | Island Medical Center; Suite 301, 4500 Sunny Isle, Christiansted, VI 00820 | 2020-10-12 |
| 1013530294 | The Turning Point Senior Care LLC | In Home Supportive Care | 246-c Estate Glynn, Kingshill, VI 00820 | 2020-05-22 |
| 1871115956 | Nneka Igwemadu | Pharmacist | Sunny Isles Shopping Center, Unit 1, St.croix, VI 00820 | 2020-05-12 |
| 1639720428 | Jade Family Therapy | Clinic/Center | 2201 Church Street, Suite 16ab Second Floor, Christiansted, VI 00820 | 2019-09-24 |
| 1003467010 | Cody Matthew Rea | Physical Therapy Assistant | 4201 (201-202) Estate Ruby, Christianstead, VI 00820 | 2019-09-23 |
| 1639723943 | Peter W Stewart | Health Educator | 2d Estate Princess, Abc Building, Christiansted, VI 00820 | 2019-07-25 |
| 1013570308 | Hunter Garrison | Physical Therapist | 201 - 202 Estate Ruby, Christiansted, VI 00820 | 2019-04-22 |
| 1154882371 | Jessica Erin Carter | Physician Assistant | 4423 Queen Mary Hwy, Christiansted, VI 00820 | 2019-03-29 |
| 1023596418 | Camille Marise Paul | Physician Assistant | 4500 Sunny Isle, Ste. 9, Island Medical Center, Christiansted, VI 00820 | 2018-07-30 |
| 1245722669 | Berlina Wallace-berube | Counselor | 100b La Grande Princesse, Christiansted, VI 00820 | 2018-06-01 |
| Find all providers in zip 00820 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154882371 | Jessica Erin Carter | Physician Assistant | 4423 Queen Mary Hwy, Christiansted, VI 00820 | 2019-03-29 |
| 1023596418 | Camille Marise Paul | Physician Assistant | 4500 Sunny Isle, Ste. 9, Island Medical Center, Christiansted, VI 00820 | 2018-07-30 |
| 1689085417 | Jennifer Arizu | Physician Assistant | Sunny Isle Shopp Ctr, Suite 301, Christiansted, VI 00820-4493 | 2014-05-14 |
| 1366404501 | Jason Alan Snow | Physician Assistant | 4100 Sion Farm Shopp Ctr Ste 5, Christiansted, VI 00820-4433 | 2006-04-04 |
| 1093170037 | Lindsey Lee Jacobson | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2015-12-17 |
| 1699171041 | Jennifer Chitolie Samuel | Physician Assistant | 4040 Estate La Grande Princess, Christiansted, VI 00820-5165 | 2014-11-12 |
| 1326315532 | John Salo | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2011-11-17 |
| 1902190572 | Keith Louis Moore | Physician Assistant | 4007 Estate Diamond Ruby, Christiansted, VI 00820-4435 | 2011-06-01 |
| 1295988699 | Tommy Lamar Ray | Physician Assistant | 4423 Estate Marys Fancy, Christiansted, VI 00820-5244 | 2008-10-29 |
| 1962458547 | Roy Zech Arcamo | Physician Assistant | 4007 Diamond Ruby, Christiansted, VI 00820-4417 | 2006-05-26 |
| Find all providers in CHRISTIANSTED | ||||
| City | CHRISTIANSTED |
| Zip Code | 00820 |
Please comment or provide details below to improve the information on ZACKERY J TEGGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.