Individual provider Active NPI

Kaydee Anne Zimmern, DPT

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1134641012
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27953 Issued in FL
Practice address
210 E Intendencia St
Pensacola, FL 32502-6023
Phone
(850) 764-1092
Fax
(850) 546-6280
NPI assigned
Jul 12, 2017
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27953 FL
Physical Therapist 225100000X PT27953 FL Primary

Addresses

Primary practice location

210 E Intendencia St
Pensacola, FL 32502-6023

Mailing address

210 E Intendencia St
Pensacola, FL 32502-6023
Phone (850) 764-1092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 Bay Bridge Dr
Gulf Breeze, FL 32561-4470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27953FLMDGeneral Practice Dentistry
PT27953FLMDPhysical Therapist

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1134641012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E INTENDENCIA ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325026023",
            "telephone_number": "850-764-1092",
            "fax_number": "850-546-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E INTENDENCIA ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325026023",
            "telephone_number": "850-764-1092",
            "fax_number": "850-546-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERN",
        "first_name": "KAYDEE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "27953",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.