Lacey Ann Zimmermann, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12326180-4201 Issued in UT

Practice address

4554 Forestdale Dr Unit E26
Park City, UT 84098-1394

Phone

(435) 400-4064

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1396187282
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Anesthesiology Physician
  • Salt Lake City, UT
  • NPI 1528556776
  NPD
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1700223559
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1255900346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N15W30191 TIMBER BROOK RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726100",
            "telephone_number": "262-344-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 FORESTDALE DR UNIT E26",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840981394",
            "telephone_number": "435-400-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "12326180-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Worley
• Samantha Worrall, CCC-SLP
• Archibald Wright III, ACMHC
• Katie Yoder, PSYD
• Lauren Ziaks, DPT, ATC, AIB-VR
• Scott Jerome Zuckerman, M.D.
• Ellie Zurbuchen

• Occupational Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.