John M Zimmerman, M.D.
Individual provider Active NPI Family Medicine Physician · Garden City, GA
NPI 1215078464 · NPPES record last updated Aug 10, 2015
Key facts
- NPI
- 1215078464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 070802 (GA)
- Practice address
- 109 Minis Ave
Garden City, GA 31408-2128 - Phone
- (912) 966-5445
- Fax
- (912) 966-5955
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070802 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U.S. Healthworks Medical Group of Washington, PS | Past | Accepting new patients | |
| Rina Roy MDPC | Family Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD152360 | OR | |
| Family Medicine Physician | 207Q00000X | 36304 | SC | |
| Family Medicine Physician | 207Q00000X | 070802 | GA | Yes |
Addresses
Primary practice location
109 Minis Ave
Garden City, GA 31408-2128
Mailing address
109 Minis Ave
Garden City, GA 31408-2128
Phone (912) 966-5445
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180226 | Other | WA | LABOR & INDUSTRIES |
Other providers in Garden City, GA
All providers in Garden City, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.