Individual provider Active NPI

Kimberly Ann Zimmer, LMSW

  • Clinical Social Worker
  • Harbor Springs, MI
National Provider Identifier
1013426535
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1131 W Conway Rd Unit B
Harbor Springs, MI 49740-9642
Phone
(231) 620-1211
NPI assigned
Sep 27, 2017
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1131 W Conway Rd Unit B
Harbor Springs, MI 49740-9642

Mailing address

PO Box 2061
Petoskey, MI 49770-2061
Phone (231) 620-1211

Other practice location 1

625 Connable Ave
Petoskey, MI 49770-2215
Phone (231) 620-1211

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XMedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220817003081 MI Practitioner - Clinical Social Worker 0840678678 Reassigns benefits to 1 organization
Practice locations: Petoskey, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1131 W Conway Rd
Unit B
Harbor Springs, MI 49740-9642
Phone (231) 753-8191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
2 C Hope LLC Clinical CurrentSince Apr 5, 2025 Accepting new patients

Locations

1131 W Conway Rd
Harbor Springs, MI 49740

1131 W Conway Rd
Unit B
Harbor Springs, MI 49740
Phone (231) 620-1211

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1013426535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2061",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702061",
            "telephone_number": "231-620-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W CONWAY RD UNIT B",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409642",
            "telephone_number": "231-620-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Connable Ave",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702215",
            "country_code": "US",
            "telephone_number": "231-620-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor Springs, MI

Sources for this page

Verify at the official NPI Registry.