Active NPI
Michael A. Zimmerman, D.M.D.
- Endodontics
- Spartanburg, SC
National Provider Identifier
1194873653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 3627
- Practice address
- 127 Southport Rd
Spartanburg, SC 29306-3815 - Phone
- (864) 595-1203
- NPI assigned
- Jan 8, 2007
- Last updated
- Aug 31, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 3627 | SC | Primary |
Addresses
Primary practice location
127 Southport Rd
Spartanburg, SC 29306-3815
Mailing address
127 Southport Rd
Spartanburg, SC 29306-3815
Phone (864) 595-1203
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3627 | SC | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael a Zimmerman, DMD, PA | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Spartanburg, SC
- NPI 1073207536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1194873653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 SOUTHPORT RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293063815",
"telephone_number": "864-595-1203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 SOUTHPORT RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293063815",
"telephone_number": "864-595-1203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "MICHAEL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "SC",
"license": "3627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.