Individual provider Active NPI

Ann Zimmerman, FNP

  • Family Nurse Practitioner
  • Roselle, IL
National Provider Identifier
1306395157
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014820 Issued in IL
Practice address
335 Stonehurst LN
Roselle, IL 60172-1848
Phone
(847) 609-4236
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209014820 IL Primary

Addresses

Primary practice location

335 Stonehurst LN
Roselle, IL 60172-1848

Mailing address

335 Stonehurst LN
Roselle, IL 60172-1848
Phone (847) 609-4236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, VA, NE, SD, NY, IN, OH7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20240205003621 MO Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization
I20240811000018 VA Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization
I20240831000538 NE Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization
I20241017001422 SD Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization
I20250801000427 NY Practitioner - Nurse Practitioner 0345538922
I20251103001339 IN Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization
I20260331002197 OH Practitioner - Nurse Practitioner 0345538922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Medical Partners of Middle Tennessee PC PastSince Jun 26, 2020 Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: azimmerman21418@carelonhealth.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/24009/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1306395157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 STONEHURST LN",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721848",
            "telephone_number": "847-609-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 STONEHURST LN",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721848",
            "telephone_number": "847-609-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

Verify at the official NPI Registry.