Individual provider Active NPI

Kevin Elmer Zimmer, CRNA

  • Certified Registered Nurse Anesthetist
  • Sauk Centre, MN
National Provider Identifier
1174586127
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 093033-2 Issued in MN
Practice address
425 Elm St N
Sauk Centre, MN 56378-1010
Phone
(320) 352-2221
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R 093033-2 MN Primary

Addresses

Primary practice location

425 Elm St N
Sauk Centre, MN 56378-1010

Mailing address

10382 Augusta Dr
Sauk Centre, MN 56378-4864
Phone (320) 351-8422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329000672 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658327028 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R 093033-2MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System - Melrose CurrentSince Jan 1, 2007 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Centracare Health System - Melrose CurrentSince Jan 1, 2007 Accepting new patients
Prairie Surgicenter LLP Past Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

1526 Northway Dr
Saint Cloud, MN 56303
Phone (320) 251-8385

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

400 10th St E
Waconia, MN 55387

Interoperability endpoints

  • Direct secure messaging: kzimmer961@direct.centracare.com

Organizations & group practices 5

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174586127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10382 AUGUSTA DR",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563784864",
            "telephone_number": "320-351-8422",
            "fax_number": "320-351-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 ELM ST N",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781010",
            "telephone_number": "320-352-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "KEVIN",
        "middle_name": "ELMER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 093033-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Centre, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.