Alec Ryan Zimmer, MD
Individual provider Active NPI Psychiatry Physician · Windsor, MO
NPI 1306462452 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1306462452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 2023045532 (MO)
- Practice address
- 307 N Main St
Windsor, MO 65360-1449 - Phone
- (844) 853-8937
- NPI assigned
- Jun 24, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240126001273 | MO | Practitioner - Psychiatry | 2769806058 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Health, Inc | Current |
Accepting new patients | |
| Compass Health, Inc | Current |
Accepting new patients | |
| Pathways Psychiatric Hospital, Inc | Past | Accepting new patients |
Locations
1800 Community
#B
Clinton, MO 64735
1800 Community
Clinton, MO 64735
Phone (660) 885-8131
307 N Main St
Windsor, MO 65360
Phone (660) 647-2182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2023045532 | MO | Yes |
Addresses
Primary practice location
307 N Main St
Windsor, MO 65360-1449
Mailing address
1 Hospital Dr
Columbia, MO 65212-1000
Phone (573) 882-8907
Other practice location 1
1 Hospital Dr
Columbia, MO 65212-1000
Phone (573) 882-8907
Other providers in Windsor, MO
- Windsor Rehabilitation & Health Care Center LLC
- George Edward Windsor
- Rosalyn D Wisniewski
- Richard A Witte
- Lisa Kay Yates
All providers in Windsor, MO · Psychiatry Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.