Individual provider Active NPI

Kendyl Zimmer, OTR/L, OTD

  • Occupational Therapist
  • Bozeman, MT
National Provider Identifier
1851089361
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTP-OT-LIC-9684 Issued in MT
Practice address
1547 Hunters Way
Bozeman, MT 59718-6170
Phone
(844) 502-7996
NPI assigned
Apr 25, 2023
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTP-OT-LIC-9684 MT Primary

Addresses

Primary practice location

1547 Hunters Way
Bozeman, MT 59718-6170

Mailing address

4256 Cover St Apt B
Bozeman, MT 59718-1987

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230627001545 MT Practitioner - Occupational Therapist in Private Practice 6305204199 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTP-OT-LIC-9684MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc CurrentSince May 1, 2023 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince May 1, 2023 Accepting new patients

Locations

4001 Bell Ave
Billings, MT 59106
Phone (406) 384-5951

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

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, 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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1851089361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 COVER ST APT B",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597181987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 HUNTERS WAY",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186170",
            "telephone_number": "844-502-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "KENDYL",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "OTP-OT-LIC-9684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.