Adam Zimmerman, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CH11737 Issued in FL

Practice address

30 S Shore Dr
Miramar Beach, FL 32550-5821

Phone

(850) 312-1456

Fax

(888) 977-1639

NPI assigned

Sep 9, 2013

Reactivated

Dec 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1285069310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S SHORE DR",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325505821",
            "telephone_number": "850-312-1456",
            "fax_number": "888-977-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S SHORE DR",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325505821",
            "telephone_number": "850-312-1456",
            "fax_number": "888-977-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2023-12-05",
        "certification_date": "2022-12-13",
        "deactivation_date": "2022-12-13",
        "reactivation_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009189",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH11737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xtreme Enterprises Inc.
• Ynr Dental Services LLC
• Erin Caton Yuknis, APRN
• Joseph N Zemis, M.D.
• Zimmerman Sports Chiropractic PLLC
• Eleanor Zimmerman, PSY.D.
• Ashleemarie Zito

• Sports Physician Chiropractor in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.

Verify at the official NPI Registry.