Individual provider Active NPI

Kelsey Collette Zimmerman, RN

  • Pediatric Registered Nurse
  • Omaha, NE
National Provider Identifier
1457987299
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
78732 Issued in NE
Practice address
5321 S 138TH St
Omaha, NE 68137-2913
Phone
(402) 895-4000
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 78732 NE Primary

Addresses

Primary practice location

5321 S 138TH St
Omaha, NE 68137-2913

Mailing address

5321 S 138TH St
Omaha, NE 68137-2913

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
78732NEMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1457987299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 S 138TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 S 138TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372913",
            "telephone_number": "402-895-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KELSEY",
        "middle_name": "COLLETTE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NE",
            "license": "78732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.