Individual provider Active NPI

Gretchen G Zima, MD

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1124214820
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME88767 Issued in FL
Practice address
1155 E 21St St
Jacksonville, FL 32206-2401
Phone
(904) 383-1040
Fax
(904) 350-9651
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME88767 FL Primary

Addresses

Primary practice location

1155 E 21St St
Jacksonville, FL 32206-2401

Mailing address

653-1 West 8TH Street
Box L-16
Jacksonville, FL 32209
Phone (904) 244-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071126000130 FL Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1153419338 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME88767FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 15, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince May 15, 2023 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

1155 E 21st St
Jacksonville, FL 32206
Phone (904) 359-9067

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1124214820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653-1 WEST 8TH STREET",
            "address_2": "BOX L-16",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-244-3050",
            "fax_number": "904-244-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E 21ST ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322062401",
            "telephone_number": "904-383-1040",
            "fax_number": "904-350-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMA",
        "first_name": "GRETCHEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME88767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.