Individual provider Active NPI

Theresa Mary Zeman, GNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rushford, MN
National Provider Identifier
1184860629
Registry record updated Apr 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP0410 Issued in MN
Practice address
30790 Zephyr Valley LN
Rushford, MN 55971-4211
Phone
(507) 330-2151
NPI assigned
Jan 6, 2009
Last updated
Apr 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R112785-6 MN
Gerontology Nurse Practitioner 363LG0600X R1127856 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP0410 MN Primary

Addresses

Primary practice location

30790 Zephyr Valley LN
Rushford, MN 55971-4211

Mailing address

30790 Zephyr Valley LN
Rushford, MN 55971-4211
Phone (507) 330-2151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20090318000678 MN Practitioner - Nurse Practitioner 6800953829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R112785-6MNMDNurse Practitioner
R1127856MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Past Accepting new patients
Nurse Practitioner Associates, LTD. Gerontology Past Accepting new patients

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, 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": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460851200000",
    "number": "1184860629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30790 ZEPHYR VALLEY LN",
            "city": "RUSHFORD",
            "state": "MN",
            "postal_code": "559714211",
            "telephone_number": "507-330-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30790 ZEPHYR VALLEY LN",
            "city": "RUSHFORD",
            "state": "MN",
            "postal_code": "559714211",
            "telephone_number": "507-330-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMAN",
        "first_name": "THERESA",
        "middle_name": "MARY",
        "credential": "GNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2016-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R112785-6",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R1127856",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP0410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rushford, MN

Sources for this page

Verify at the official NPI Registry.