Individual provider Active NPI

Samantha Kylie Zimmer, DNP, CNM, WHNP

  • Midwife
  • Layton, UT
National Provider Identifier
1114225802
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
10441485-4402 Issued in UT
Practice address
1289 E 1325 N
Layton, UT 84040-2809
Phone
(801) 512-9326
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 10441485-4402 UT Primary

Addresses

Primary practice location

1289 E 1325 N
Layton, UT 84040-2809

Mailing address

1289 E 1325 N
Layton, UT 84040-2809
Phone (801) 512-9326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231228002952 CO Practitioner - Certified Nurse Midwife (CNM) 1951751239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Health Physicians Colorado LLCGroup PAC ID 8921273038, 278 clinicians

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

4700 Lady Moon Dr
Fort Collins, CO 80528-4426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10441485-4402UTMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Jan 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Jan 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

4700 Lady Moon Dr
Ste C1
Fort Collins, CO 80528
Phone (970) 821-4500

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1114225802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 E 1325 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840402809",
            "telephone_number": "801-512-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 E 1325 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840402809",
            "telephone_number": "801-512-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "SAMANTHA",
        "middle_name": "KYLIE",
        "name_prefix": "Dr.",
        "credential": "DNP, CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "UT",
            "license": "10441485-4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.