Individual provider Active NPI

Penny Zimmerman, MSW, LSW

  • Social Worker
  • Silver Spring, MD
National Provider Identifier
1497082044
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S31699 Issued in OH
Practice address
12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699
Phone
(240) 780-8884
NPI assigned
Nov 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S31699 OH Primary

Addresses

Primary practice location

12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699

Mailing address

12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699
Phone (240) 780-8884

Other identifiers 1

IdentifierTypeStateIssuer
2296215MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190211001948 MD Practitioner - Clinical Social Worker 3375722283 Reassigns benefits to 1 organization
I20190211002256 DC Practitioner - Clinical Social Worker 3375722283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychcare Psychological Services LLCGroup PAC ID 2264660133, 19 clinicians

Practice addresses (Care Compare)

12501 Prosperity Dr
Suite 310
Silver Spring, MD 20904-1699
Phone (410) 343-9756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S31699OHMDSocial Worker
20488MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychcare Psychological Services, LLC CurrentSince Feb 1, 2019 Accepting new patients
Wellspring Past Accepting new patients

Locations

104 Church Ln
Ste 101102
Pikesville, MD 21208
Phone (410) 343-9756

12501 Prosperity Dr
Ste 310
Silver Spring, MD 20904
Phone (240) 780-8884

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1497082044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 310",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041699",
            "telephone_number": "240-780-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 310",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041699",
            "telephone_number": "240-780-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "PENNY",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-03",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S31699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2296215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.