Organization Active NPI

Oak Haven Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1386309318
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OAK HAVEN PSYCHIATRY, LLC
Practice address
730 Fairview Ave Ste A5
Bowling Green, KY 42101-2383
Phone
(270) 935-5117
Fax
(270) 935-5118
NPI assigned
Nov 4, 2021
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Dr. Kimberly Zimmerman, DNP, APRNNPI 1902146020
Title
Pmhnp-BC, FNP-C, Owner
Phone
(270) 935-5117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

730 Fairview Ave Ste A5
Bowling Green, KY 42101-2383

Mailing address

PO Box 50754
Bowling Green, KY 42102-3954
Phone (270) 935-5117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220218000264 KY Part B Supplier - Clinic/Group Practice 4880088798 Receives reassigned benefits from 1 practitioner
Practice locations: Bowling Green, KY

National Provider Directory

National Provider Directory

Locations

730 Fairview Ave
Ste A5
Bowling Green, KY 42101
Phone (270) 935-5117

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1386309318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50754",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421023954",
            "telephone_number": "270-935-5117",
            "fax_number": "270-935-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 FAIRVIEW AVE STE A5",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012383",
            "telephone_number": "270-935-5117",
            "fax_number": "270-935-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK HAVEN PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PMHNP-BC, FNP-C, OWNER",
        "authorized_official_telephone_number": "270-935-5117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.