Individual provider Active NPI

Jill Zimmerman

  • Certified Registered Nurse Anesthetist
  • Fargo, ND
National Provider Identifier
1730575861
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R41645 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-6761
NPI assigned
Apr 15, 2015
Last updated
Apr 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R41645 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-6761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160303000706 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416268339 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians
Alomere HealthGroup PAC ID 9931690047, 123 clinicians
TTB Services Prof LLCGroup PAC ID 3476797135, 23 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

2600 Jefferson St
Suite 100
Alexandria, MN 56308-3410
Phone (320) 335-2167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1835MNMDProfessional Counselor
R41645NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince Aug 1, 2022 Accepting new patients
Regional Anesthesia Services PA CurrentSince Jan 11, 2016 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2022 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2022 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Glacial Ridge Hospital District CurrentSince Aug 1, 2022 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince May 14, 2018 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2022 Accepting new patients
Allina Health System CurrentSince May 14, 2018 Accepting new patients
TTB Services Prof LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

2600 Jefferson St
Ste 100
Alexandria, MN 56308
Phone (320) 335-2167

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

13911 Ridgedale Dr
Ste 404B
Minnetonka, MN 55305
Phone (612) 636-0061

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1730575861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R41645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.