NPIMap

Individual provider Active NPI

Kirk Karl Zimbelman, PH,D,

  • Clinical Psychologist
  • Yankton, SD
National Provider Identifier
1811270168
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
498 Issued in SD
Practice address
904 W 23Rd St
Suite 101
Yankton, SD 57078-1216
Phone
(605) 665-0841
Fax
(605) 665-0096
NPI assigned
Sep 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 498 SD Primary

Addresses

Primary practice location

904 W 23Rd St
Suite 101
Yankton, SD 57078-1216

Mailing address

904 W 23Rd St
Suite 101
Yankton, SD 57078-1216
Phone (605) 665-0841

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of South Dakota Past Accepting new patients
Heartland Psychological Services Past Accepting new patients
State of South Dakota Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1811270168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W 23RD ST",
            "address_2": "SUITE 101",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781216",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W 23RD ST",
            "address_2": "SUITE 101",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781216",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMBELMAN",
        "first_name": "KIRK",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "PH,D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SD",
            "license": "498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.