Individual provider Active NPI

Kristen Zimmerman, CRNP

  • Adult Health Nurse Practitioner
  • Westminster, MD
National Provider Identifier
1144050253
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R233796 Issued in MD
Practice address
200 Memorial Ave
Westminster, MD 21157-5726
Phone
(410) 871-7890
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R233796 MD
Adult Health Nurse Practitioner 363LA2200X R233796 MD Primary

Addresses

Primary practice location

200 Memorial Ave
Westminster, MD 21157-5726

Mailing address

292 Stoner Ave
Westminster, MD 21157-5629

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120001414 MD Practitioner - Nurse Practitioner 5799210365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridginglife, Inc.Group PAC ID 4880797943, 11 clinicians

Practice addresses (Care Compare)

292 Stoner Ave
Westminster, MD 21157-5629
Phone (410) 871-8000

Hospital & facility affiliations

  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bridginglife, Inc. CurrentSince Oct 25, 2024 Accepting new patients
Bridginglife, Inc. CurrentSince Oct 25, 2024 Accepting new patients

Locations

292 Stoner Ave
Westminster, MD 21157
Phone (443) 974-8725

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1144050253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 STONER AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575726",
            "telephone_number": "410-871-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KRISTEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R233796",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R233796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.