NPIMap

Individual provider Active NPI

Zachary Daniel Pruemer, PT, DPT

  • Physical Therapist
  • Effingham, IL
National Provider Identifier
1245990035
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070026104 Issued in IL
Practice address
1301 N Maple St
Effingham, IL 62401-1779
Phone
(217) 347-1243
Fax
(217) 347-1558
NPI assigned
Dec 21, 2021
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070026104 IL Primary

Addresses

Primary practice location

1301 N Maple St
Effingham, IL 62401-1779

Mailing address

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 347-1243

Other practice location 1

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zpruemer247071@ewd.direct.hshs.org Direct

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 22, 2024 Accepting new patients
William H and Carrie Gottsche Foundation CurrentSince May 22, 2023 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third PastSince Dec 26, 2021 Accepting new patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients

Locations

1527 N Park Dr
Winslow, AZ 86047

500 Indiana Ave
Winslow, AZ 86047

148 E Arapahoe St
Thermopolis, WY 82443
Phone (307) 864-0003

Interoperability endpoints

  • Direct secure messaging: zpruemer247071@ewd.direct.hshs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1245990035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012006",
            "telephone_number": "217-347-1243",
            "fax_number": "217-347-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011779",
            "telephone_number": "217-347-1243",
            "fax_number": "217-347-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "503 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012006",
            "country_code": "US",
            "telephone_number": "217-342-2121",
            "fax_number": "217-347-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUEMER",
        "first_name": "ZACHARY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070026104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zpruemer247071@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "503 N Maple St",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.