Active NPI
Kenneth Carl Zimmerman, LISW
- Social Worker
- Mason City, IA
National Provider Identifier
1356358949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 00049
- Practice address
- 1522 6TH St SW
Mason City, IA 50401-4820 - Phone
- (641) 512-5565
- Fax
- (641) 512-5565
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 00049 | IA | Primary |
Addresses
Primary practice location
1522 6TH St SW
Mason City, IA 50401-4820
Mailing address
PO Box 379
Mason City, IA 50402-0379
Phone (641) 512-5565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00049 | IA | MD | Social Worker |
| 49 | IA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellsource | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
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": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214179200000",
"number": "1356358949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 379",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504020379",
"telephone_number": "641-512-5565",
"fax_number": "641-512-5565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1522 6TH ST SW",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504014820",
"telephone_number": "641-512-5565",
"fax_number": "641-512-5565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "KENNETH",
"middle_name": "CARL",
"name_prefix": "Mr.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2008-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "00049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mason City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.