Fawn Zimmer, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015035378 Issued in MO

Practice address

206 N Bismark St Ste a
Concordia, MO 64020-8101

Phone

(877) 344-3572

Fax

(866) 228-4492

NPI assigned

Oct 7, 2015

Last updated

May 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fawn.zimmer@hccnet.eclinicaldirectplus.com

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.

• HCC Network

  dba Live Well Community Health Center-Waverly

  • Federally Qualified Health Center (FQHC)
  • Waverly, MO
  • NPI 1174960769
  Medicare reassignment
• HCC Network

  dba Live Well Community Health Center-Concordia

  • Federally Qualified Health Center (FQHC)
  • Concordia, MO
  • NPI 1992142582
  NPD
• HCC Network

  dba Live Well Community Health Center Buckner

  • Federally Qualified Health Center (FQHC)
  • Buckner, MO
  • NPI 1174992374
  NPD (past)
• HCC Network

  • Federally Qualified Health Center (FQHC)
  • Carrollton, MO
  • NPI 1255114559
  NPD (past)
• Marana Health Center, Inc

  dba MHC Integrated Care Pharmacy

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1154792810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 S BUSINESS HIGHWAY 13",
            "city": "LEXINGTON",
            "state": "MO",
            "postal_code": "640671515",
            "telephone_number": "816-330-6426",
            "fax_number": "660-259-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N BISMARK ST STE A",
            "city": "CONCORDIA",
            "state": "MO",
            "postal_code": "640208101",
            "telephone_number": "877-344-3572",
            "fax_number": "866-228-4492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 S Business Highway 13 Ste A",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MO",
            "postal_code": "640671572",
            "country_code": "US",
            "telephone_number": "877-344-3572",
            "fax_number": "866-228-4492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "MO",
            "postal_code": "646332341",
            "country_code": "US",
            "telephone_number": "877-344-3572",
            "fax_number": "866-228-4492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 S Hudson St",
            "address_purpose": "LOCATION",
            "city": "Buckner",
            "state": "MO",
            "postal_code": "640168142",
            "country_code": "US",
            "telephone_number": "877-344-3572",
            "fax_number": "866-228-4492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "608 Missouri St",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "MO",
            "postal_code": "640968241",
            "country_code": "US",
            "telephone_number": "877-344-3572",
            "fax_number": "866-228-4492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "FAWN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8647",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015035378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420026294",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warrensburg Optical Inc (Insight Eyecare)
• Waterfall Chiropractic LLC
• Western Missouri Medical Center (Western Missouri Family Healthcare - Concordia)
• Western Missouri Medical Center (Western Missouri Family Healthcare-Concordia)
• Western Missouri Nursing and Rehab LLC (Lutheran Nursing Home)

• Family Nurse Practitioner in Concordia, MO
• Providers in Concordia, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.