Individual provider Active NPI

Michelle Zimmerman, NP

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1699862722
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
91959-3795 Issued in LA
Practice address
4820 Lake St
Lake Charles, LA 70605-6010
Phone
(337) 310-7378
Fax
(337) 310-7382
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 91959-3795 LA Primary

Addresses

Primary practice location

4820 Lake St
Lake Charles, LA 70605-6010

Mailing address

PO Box 4591
Lake Charles, LA 70606-4591
Phone (337) 310-7378

Other identifiers 1

IdentifierTypeStateIssuer
1034002MedicaidLA

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
91959-3795LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Disorder Center of Louisiana, LLC Current Accepting new patients

Locations

4820 Lake St
Ste 2
Lake Charles, LA 70605
Phone (337) 310-7378

4820 Lake St
Lake Charles, LA 70605
Phone (337) 310-7378

Interoperability endpoints

  • Direct secure messaging: michellezimmerman@sdcl.allscriptsdirect.net

Organizations & group practices 1

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1699862722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4591",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706064591",
            "telephone_number": "337-310-7378",
            "fax_number": "337-310-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 LAKE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056010",
            "telephone_number": "337-310-7378",
            "fax_number": "337-310-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "91959-3795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034002",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.