Active NPI
Candis Zimmerman
- Counselor
- Humble, TX
National Provider Identifier
1801483110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 84186
- Practice address
- 12202 Fall River Pass LN
Humble, TX 77346-4570 - Phone
- (166) 239-2875
- NPI assigned
- Dec 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 84186 | TX | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
12202 Fall River Pass LN
Humble, TX 77346-4570
Mailing address
12202 Fall River Pass LN
Humble, TX 77346-4570
Phone (166) 239-2875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2323 S Voss Rd
Suite 203J
Houston, TX 77057-3814
Phone (240) 201-3386
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84186 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sailor Health Medical PA | Counselor | Current | Accepting new patients |
Locations
2332 Galiano St
#2
Coral Gables, FL 33134
Phone (305) 998-0546
2323 S Voss Rd
Ste 203J
Houston, TX 77057
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": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1801483110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12202 FALL RIVER PASS LN",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464570",
"telephone_number": "166-239-2875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12202 FALL RIVER PASS LN",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464570",
"telephone_number": "166-239-2875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "CANDIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-22",
"last_updated": "2020-12-22",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "84186",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.