Active NPI
Corey Lynn Zimmerman, R. PH.
- Pharmacist
- Martinsburg, WV
National Provider Identifier
1093809063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13931
- Practice address
- 510 Butler Ave
Martinsburg, WV 25401-9990 - Phone
- (304) 263-0811
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13931 | MD | Primary |
Addresses
Primary practice location
510 Butler Ave
Martinsburg, WV 25401-9990
Mailing address
102 Ambers Way
Smithsburg, MD 21783-2010
Phone (301) 824-1027
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13931 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093809063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 AMBERS WAY",
"city": "SMITHSBURG",
"state": "MD",
"postal_code": "217832010",
"telephone_number": "301-824-1027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 BUTLER AVE",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254019990",
"telephone_number": "304-263-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "COREY",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "R. PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "13931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.