Individual provider Active NPI

Jennifer Zimmerman, RD, CDCES

  • Registered Dietitian
  • The Dalles, OR
National Provider Identifier
1265057772
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
551 Lone Pine Blvd
The Dalles, OR 97058-9403
Phone
(541) 296-1111
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

551 Lone Pine Blvd
The Dalles, OR 97058-9403

Mailing address

PO Box 1580
The Dalles, OR 97058-8004
Phone (541) 296-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200701000211 OR Practitioner - Registered Dietitian Or Nutrition Professional 2264855709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Columbia Gorge Medical Center PCGroup PAC ID 8628066115, 12 clinicians

Practice addresses (Care Compare)

1750 12TH St
Hood River, OR 97031-9540
Phone (541) 386-5070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Mar 20, 2020 Accepting new patients
Columbia Gorge Medical Center PC CurrentSince Jul 1, 2025 Accepting new patients
Mid-Columbia Medical Center CurrentSince Mar 20, 2020 Accepting new patients
Columbia Gorge Medical Center PC CurrentSince Jul 1, 2025 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

1750 12th St
Hood River, OR 97031
Phone (541) 386-5070

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

Organizations & group practices 6

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1265057772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1580",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588004",
            "telephone_number": "541-296-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 LONE PINE BLVD",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589403",
            "telephone_number": "541-296-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JENNIFER",
        "credential": "RD, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.