Individual provider Active NPI

Margaret Jane Zimmerman, PA

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1295205771
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08592 Issued in NC
Practice address
7331 College Pkwy Ste 300
Fort Myers, FL 33907-5524
Phone
(239) 337-2003
NPI assigned
Nov 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08592 NC Primary

Addresses

Primary practice location

7331 College Pkwy Ste 300
Fort Myers, FL 33907-5524

Mailing address

4705 South Blvd
Charlotte, NC 28217

Other practice location 1

4705 South Blvd
Charlotte, NC 28217
Phone (704) 525-6288

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-08592NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Health Carolinas, PLLC PastSince May 5, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1295205771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7331 COLLEGE PKWY STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075524",
            "telephone_number": "239-337-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4705 South Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28217",
            "country_code": "US",
            "telephone_number": "704-525-6288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MARGARET",
        "middle_name": "JANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.