Individual provider Active NPI

Diane M Zimmerman, MSW, LCSW

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1356053045
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023014190 Issued in MO
Practice address
1106 N 20TH St
Quincy, IL 62301-2006
Phone
(217) 779-0339
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2023014190 MO Primary
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-58059 MT

Addresses

Primary practice location

1106 N 20TH St
Quincy, IL 62301-2006

Mailing address

1106 N 20TH St
Quincy, IL 62301-2006
Phone (217) 779-0339

Other practice location 1

235 Progress
Hannibal, MO 63401
Phone (573) 603-1460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230519002530 MO Practitioner - Clinical Social Worker 9931565785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-58059MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Family Healthcare, Inc CurrentSince Apr 27, 2023 Accepting new patients
Preferred Family Healthcare, Inc. CurrentSince Apr 27, 2023 Accepting new patients

Locations

141 Communication Dr
Hannibal, MO 63401
Phone (573) 795-7342

235 Progress Rd
Hannibal, MO 63401
Phone (573) 603-1462

3531 Stardust Dr
Hannibal, MO 63401
Phone (573) 248-3900

900 E Laharpe St
Kirksville, MO 63501

116 W 7th Ave
Ste 222
Stillwater, OK 74074
Phone (405) 743-2945

Interoperability endpoints

  • Direct secure messaging: diane.zimmerman.p1@direct.pfh.nextgenshare.com

Organizations & group practices 2

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1356053045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N 20TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012006",
            "telephone_number": "217-779-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N 20TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012006",
            "telephone_number": "217-779-0339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Progress",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "63401",
            "country_code": "US",
            "telephone_number": "573-603-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023014190",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-58059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.