Individual provider Active NPI

Clare Cadagin Zimmerman, M.D.

  • Pediatric Hematology & Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1902291735
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
036157065 Issued in IL
Practice address
1 Childrens PL CB 8116
Saint Louis, MO 63110
Phone
(314) 454-6018
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 036157065 IL Primary
Pediatrics Physician 208000000X 2018010722 MO

Addresses

Primary practice location

1 Childrens PL CB 8116
Saint Louis, MO 63110

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-7731

Other practice location 1

400 N 9th St Fl 3
Springfield, IL 62702-5310
Phone (217) 545-8000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728000821 IL Practitioner - Pediatric Medicine 3870996804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018010722MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 9, 2021 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 9, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

400 N 9th St
Springfield, IL 62702
Phone (217) 545-6498

201 E Madison St
Ste 328
Springfield, IL 62702

400 N 9th St
Fl 3
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: czimmerman623431@direct.carenet.org
  • Direct secure messaging: clarezimmerman@siusm.allscriptsdirect.net

Organizations & group practices 4

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1902291735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL CB 8116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-6018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N 9th St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025310",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CLARE",
        "middle_name": "CADAGIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IL",
            "license": "036157065",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018010722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.