Active NPI
Kristie Zimmerman, NP
- Family Nurse Practitioner
- Waverly, TN
National Provider Identifier
1154910230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 28102
- Practice address
- 301 W Main St
Waverly, TN 37185-1512 - Phone
- (931) 299-7378
- Fax
- (931) 299-7399
- NPI assigned
- Jan 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28102 | TN | Primary |
Addresses
Primary practice location
301 W Main St
Waverly, TN 37185-1512
Mailing address
120 Atchison Rd
Springville, TN 38256-6455
Phone (731) 363-0724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
301 W Main St
Waverly, TN 37185-1512
Phone (615) 988-1571
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients |
Locations
284 Highway 641 N
Camden, TN 38320
Phone (731) 213-2446
301 W Main St
Waverly, TN 37185
Phone (931) 299-7378
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.
-
- Family Medicine Physician
- Spring Hill, TN
- NPI 1134452865
-
- Rural Health Clinic/Center
- Chapel Hill, TN
- NPI 1316602774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1154910230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 ATCHISON RD",
"city": "SPRINGVILLE",
"state": "TN",
"postal_code": "382566455",
"telephone_number": "731-363-0724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W MAIN ST",
"city": "WAVERLY",
"state": "TN",
"postal_code": "371851512",
"telephone_number": "931-299-7378",
"fax_number": "931-299-7399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "KRISTIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-13",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "28102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waverly, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.
- 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.