Individual provider Active NPI

Micah D Zimmerman, CRNA

  • Certified Registered Nurse Anesthetist
  • Rice Lake, WI
National Provider Identifier
1285042572
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6198 Issued in WI
Practice address
2200 Cedar Crest Dr Ste B
Rice Lake, WI 54868-5500
Phone
(608) 346-6793
NPI assigned
Jul 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 179953-030 WI
Certified Registered Nurse Anesthetist 367500000X 6198 WI Primary

Addresses

Primary practice location

2200 Cedar Crest Dr Ste B
Rice Lake, WI 54868-5500

Mailing address

1812 20TH Ave
Rice Lake, WI 54868-8523
Phone (608) 346-6793

Other practice location 1

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Other practice location 2

1222 E Woodland Ave
Barron, WI 54812-1765
Phone (715) 537-3166

Other practice location 3

1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-4450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150219000131 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345565180 Reassigns benefits to 14 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6198WIMDOccupational Therapist
179953-030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc CurrentSince May 8, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Memorial Hospital Inc CurrentSince May 8, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince May 8, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Dec 27, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 8, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Midwest Anesthesia Care, Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince May 8, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince May 8, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Memorial Hospital Inc CurrentSince May 8, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 8, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 8, 2024 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince May 8, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Dec 27, 2020 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

1601 Highway 13 E
Ste 110
Burnsville, MN 55337
Phone (952) 322-8532

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

400 10th St E
Waconia, MN 55387

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

2200 Cedar Crest Dr
Ste B
Rice Lake, WI 54868
Phone (586) 864-6006

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1285042572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 20TH AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688523",
            "telephone_number": "608-346-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CEDAR CREST DR STE B",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685500",
            "telephone_number": "608-346-6793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-251-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1222 E Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Barron",
            "state": "WI",
            "postal_code": "548121765",
            "country_code": "US",
            "telephone_number": "715-537-3166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 W Stout St",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548685000",
            "country_code": "US",
            "telephone_number": "715-236-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MICAH",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "179953-030",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "6198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1700 W Stout St",
            "city": "Rice Lake",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548685000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.