CMS-1500 Box 24J / 33a • NPI
1184860629
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
30790 ZEPHYR VALLEY LN, RUSHFORD, MN, 55971-4211
✓ 9-Digit EDI 837 ZIP+4 (55971-4211)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184860629 (THERESA MARY ZEMAN, GNP-BC, PMHNP-BC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184860629 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | THERESA MARY ZEMAN, GNP-BC, PMHNP-BC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 30790 ZEPHYR VALLEY LN, RUSHFORD, MN, 55971-4211 |
| Practice Telephone / Fax | Tel: (507) 330-2151 |
| Administrative Mailing Address | 30790 ZEPHYR VALLEY LN, RUSHFORD, MN, 55971-4211 |
| Enumeration & Last Sync | Enumerated: 2009-01-06 | CMS Record Updated: 2016-04-17 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (THERESA MARY ZEMAN, GNP-BC, PMHNP-BC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: MN | License: R112785-6 | Primary: Secondary |
363LG0600X — Nurse Practitioner, GerontologyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology | State: MN | License: R1127856 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: MN | License: CNP0410 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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