Individual provider Active NPI

Nichole Zimdars, NNP-BC

  • Neonatal Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1548047434
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1413033 Issued in WI
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 365-1000
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1413033 WI Primary

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

232351 Sandy Ridge LN
Wausau, WI 54403-9020
Phone (715) 595-3161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231128002569 MN Practitioner - Nurse Practitioner 7315395563 Reassigns benefits to 4 organizations
I20260316000385 WI Practitioner - Nurse Practitioner 7315395563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

29980 Network PL
Chicago, IL 60673-1299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10878MNMDDentist
1413033WIMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Nov 1, 2023 Accepting new patients
Fairview Health Services CurrentSince Nov 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Nov 1, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Nov 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Mar 1, 2026 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Mar 1, 2026 Accepting new patients
Healtheast Medical Research Institute CurrentSince Nov 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2023 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Interoperability endpoints

  • Direct secure messaging: nzimdars838958@fairview.direct-ci.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1548047434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232351 SANDY RIDGE LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544039020",
            "telephone_number": "715-595-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-365-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMDARS",
        "first_name": "NICHOLE",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "1413033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.