Willowdale Internal Medicine Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD056655L Issued in PA

Legal business name

WILLOWDALE INTERNAL MEDICINE ASSOCIATES LLC

Practice address

127 W Street Rd
Suite 101
Kennett Square, PA 19348-1698

Phone

(610) 444-1212

Fax

(610) 444-3633

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Karl A Zimmerman, MDNPI 1154439966

Title

Owner

Phone

(610) 444-1212

Specialties & licenses 1

Addresses

Other names 1

• Karl Zimmerman MD LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karl A. Zimmerman, MD

  • Internal Medicine Physician
  • Kennett Square, PA
  • NPI 1154439966
  Medicare reassignment NPD Authorized official
• Michele Leigh Zimmerman, C.R.N.P.

  • Primary Care Nurse Practitioner
  • Kennett Square, PA
  • NPI 1730332768
  Medicare reassignment NPD
• Colleen R Bradley, PA-C

  • Physician Assistant
  • Kennett Square, PA
  • NPI 1932811825
  Medicare reassignment
• Mary Dodson, CRNP

  • Nurse Practitioner
  • West Grove, PA
  • NPI 1316136625
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1649300161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W STREET RD",
            "address_2": "SUITE 101",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481698",
            "telephone_number": "610-444-1212",
            "fax_number": "610-444-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STREET RD",
            "address_2": "SUITE 101",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481698",
            "telephone_number": "610-444-1212",
            "fax_number": "610-444-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWDALE INTERNAL MEDICINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-444-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD056655L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Karl Zimmerman MD LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Brooke Michele Williams
• Tiffany Williams, M.ED., CCC-SLP
• Victoria Lynne Williams, OTR/L
• Willow Tree Hospice LLC
• Willowdale Family Dentistry PLLC
• David Warren Wilson, M.ED.
• Sydney Yvonne Wilson
• Joanne Mizii Wisely, SPEECH-LANGUAGE PATH
• Jeremy Wist
• Lanore Alice Wisz, PTA

• Internal Medicine Physician in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.