Individual provider Active NPI

Kayla Zimmerman, APN, CNP

  • Nurse Practitioner
  • Washington, IL
National Provider Identifier
1730686015
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017497 Issued in IL
Practice address
10 Saint Clare CT Ste 100
Washington, IL 61571-9239
Phone
(309) 886-4000
Fax
(309) 886-4101
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041412855 IL
Nurse Practitioner 363L00000X 209017497 IL Primary

Addresses

Primary practice location

10 Saint Clare CT Ste 100
Washington, IL 61571-9239

Mailing address

10 Saint Clare CT Ste 100
Washington, IL 61571-9239
Phone (309) 886-4000

Other names 1

  • Kayla Sasso Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180517000010 IL Practitioner - Nurse Practitioner 4284999475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

10 Saint Clare CT
Washington, IL 61571-9239
Phone (309) 886-4000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041412855ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince May 7, 2018 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

10 Saint Clare Ct
Ste 100
Washington, IL 61571
Phone (309) 886-4000

10 Saint Clare Ct
Washington, IL 61571
Phone (309) 886-4000

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1730686015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAINT CLARE CT STE 100",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719239",
            "telephone_number": "309-886-4000",
            "fax_number": "309-886-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAINT CLARE CT STE 100",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719239",
            "telephone_number": "309-886-4000",
            "fax_number": "309-886-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KAYLA",
        "credential": "APN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041412855",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "SASSO",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, IL

Sources for this page

Verify at the official NPI Registry.