Individual provider Active NPI

Jennifer Zimmerman-Bates, MSN, AG-CNS, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wyomissing, PA
National Provider Identifier
1760130090
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP025490 Issued in PA
Practice address
2201 Ridgewood Rd Ste 400
Wyomissing, PA 19610-1193
Phone
(610) 378-9601
NPI assigned
Mar 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP025490 PA Primary

Addresses

Primary practice location

2201 Ridgewood Rd Ste 400
Wyomissing, PA 19610-1193

Mailing address

77 Hickory St
Schuylkill Haven, PA 17972-1835
Phone (570) 640-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220520000012 PA Practitioner - Nurse Practitioner 8820475494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DGR Management Inc.Group PAC ID 0941398184, 16 clinicians

Practice addresses (Care Compare)

2201 Ridgewood Rd
Suite 400
Wyomissing, PA 19610-1193
Phone (610) 378-9601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP025490PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DGR Management Inc. CurrentSince Apr 4, 2022 Accepting new patients

Locations

2201 Ridgewood Rd
Ste 400
Wyomissing, PA 19610
Phone (610) 378-9601

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1760130090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HICKORY ST",
            "city": "SCHUYLKILL HAVEN",
            "state": "PA",
            "postal_code": "179721835",
            "telephone_number": "570-640-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD RD STE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101193",
            "telephone_number": "610-378-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN-BATES",
        "first_name": "JENNIFER",
        "credential": "MSN, AG-CNS, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.