Terisa Joann Zimmerman, MS, LAT, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

AT-774 Issued in ID

Practice address

2000 S Millenium Way
Meridian, ID 83642-1551

Phone

(208) 871-8359

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1194494492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 S OWYHEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053343",
            "telephone_number": "208-871-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S MILLENIUM WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421551",
            "telephone_number": "208-871-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "TERISA",
        "middle_name": "JOANN",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "ID",
            "license": "AT-774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J Zielicke, D.O.
• Katelyn L Ziemann, LMT
• Paige Ziemer, FNP
• Damon Bernard Zimmerman, MA
• Heather R Zimmerman
• Laura J Zoellner, MD
• Sarah Zucker
• Mary Zuercher, DPT
• Chris Zukowski, LPC
• Kylee Zweifel

• Sports Medicine (Emergency Medicine) Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Sports Medicine (Emergency Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.