Dr Mark M Zimmer PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

01967 Issued in IA

Legal business name

DR MARK M ZIMMER PC

Practice address

216 2ND St NE
Independence, IA 50644-1910

Phone

(319) 334-3631

NPI assigned

Nov 24, 2006

Organization subpart

Yes

Parent organization

DR MARK M ZIMMERAs reported in NPPES

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

Authorized official

Name

Dr. Mark Matthew Zimmer II, OD

Title

President

Phone

(319) 444-2126

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Belle Plaine Family Eyecare Doing business as

Part of

Dr Mark M Zimmer PC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Dr Mark M Zimmer PC

  • Optometrist
  • Oelwein, IA
  • NPI 1710078019
  NPPES parent name

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1285700153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 2ND ST NE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506441910",
            "telephone_number": "319-334-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 2ND ST NE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506441910",
            "telephone_number": "319-334-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK M ZIMMER PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR MARK M ZIMMER",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-444-2126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078170",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "43738",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4686720003",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Belle Plaine Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bhasker Jethalal Dave, MD
• Randolfo De Leon, M.D.
• Kimberly Deterding, LAC; LMT
• Sarah Rae Devore, ARNP
• Connie R Divis, RPH
• Dr. Mark M. Zimmer P.C
• Emerald Bridges Family Therapy, LLC
• Neil L. Evans, PH. D.
• David Lawrence Fahey, D.O..
• Family First Chiropractic P.C.

• Optometrist in Independence, IA
• Providers in Independence, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.