Individual provider Active NPI

Jeffry A Zimmerman, P.A.

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1013919505
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001164 Issued in VA
Practice address
5801 Bremo Rd
St Francis Emergency Department
Richmond, VA 23226-1907
Phone
(804) 287-7066
Fax
(804) 673-9531
NPI assigned
Aug 15, 2005
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001164 VA Primary
Emergency Medicine Physician 207P00000X 0110001164 VA

Addresses

Primary practice location

5801 Bremo Rd
St Francis Emergency Department
Richmond, VA 23226-1907

Mailing address

1700 Capeway Rd
Powhatan, VA 23139-7323

Other practice location 1

2525 NW Expressway St Ste 102
Oklahoma City, OK 73112-7200
Phone (405) 213-0192

Other practice location 2

7200 Glen Forest Dr
Richmond, VA 23226-3768
Phone (702) 848-4443

Other identifiers 1

IdentifierTypeStateIssuer
0110001164OtherVABOARD OF MEDICINE

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2271NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth NV Wagner PC Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
St Francis Emergency Associates Inc Emergency Medicine Past Accepting new patients
Emergency Physicians of Southern Virginia LLP Emergency Medicine Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Danville Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Virginia Emergency Associates Inc Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Organizations & group practices 11

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1013919505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CAPEWAY RD",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "address_2": "ST FRANCIS EMERGENCY DEPARTMENT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-287-7066",
            "fax_number": "804-673-9531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 NW Expressway St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731127200",
            "country_code": "US",
            "telephone_number": "405-213-0192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7200 Glen Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232263768",
            "country_code": "US",
            "telephone_number": "702-848-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JEFFRY",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001164",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0110001164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MEDICINE",
            "identifier": "0110001164",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.