Individual provider Active NPI

Damian A Zimmerman

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1275905135
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1502378 Issued in OH
Practice address
10701 East Blvd
Cleveland, OH 44106-1702
Phone
(216) 791-3800
NPI assigned
Oct 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC011344 OH
Clinical Social Worker 1041C0700X I.1502378 OH Primary

Addresses

Primary practice location

10701 East Blvd
Cleveland, OH 44106-1702

Mailing address

10701 East Blvd
Cleveland, OH 44106-1702
Phone (216) 791-3800

Other practice location 1

1660 Nave Rd SE
Massillon, OH 44646-9604
Phone (330) 837-9411

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

State licenses

LicenseStateTypeSpecialty
LICDC011344OHMDAddiction (Substance Use Disorder) Counselor
I.1502378OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1275905135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 Nave Rd SE",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446469604",
            "country_code": "US",
            "telephone_number": "330-837-9411",
            "fax_number": "330-837-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "DAMIAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC011344",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1502378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.