NPIMap

Individual provider Active NPI

Nicole Zimmer

  • Family Medicine Physician
  • Midland, MI
National Provider Identifier
1306374673
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301112552 Issued in MI
Practice address
4611 Campus Ridge Dr
Midland, MI 48640-9533
Phone
(989) 839-3500
Fax
(989) 839-3344
NPI assigned
May 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301112552 MI Primary

Addresses

Primary practice location

4611 Campus Ridge Dr
Midland, MI 48640-9533

Mailing address

4611 Campus Ridge Dr
Midland, MI 48640-9533
Phone (989) 839-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210730001891 MI Practitioner - Family Practice 6507136033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

335 E Houghton Ave
West Branch, MI 48661-1127
Phone (989) 345-8130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301112552MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Gladwin CurrentSince Sep 27, 2023 Accepting new patients
Mymichigan Medical Center Alma Family Medicine CurrentSince Sep 30, 2021 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Sep 27, 2023 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients
Mymichigan Medical Center West Branch Past Accepting new patients
Mymichigan Medical Center Midland PastSince Jul 24, 2022 Accepting new patients
Mymichigan Medical Center Midland Family Medicine PastSince Jul 24, 2022 Accepting new patients
Mymichigan Medical Group Past Accepting new patients

Locations

330 E Warwick Dr
Alma, MI 48801
Phone (989) 466-3330

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

121 N Pine River St
Ithaca, MI 48847
Phone (989) 875-0662

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

2431 S M 30
Ste 200
West Branch, MI 48661
Phone (989) 343-3762

335 E Houghton Ave
Ste B
West Branch, MI 48661

335 E Houghton Ave
West Branch, MI 48661
Phone (989) 343-3154

Interoperability endpoints

  • Direct secure messaging: nzimmer11354@mymichiganhealth.midirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306374673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 CAMPUS RIDGE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486409533",
            "telephone_number": "989-839-3500",
            "fax_number": "989-839-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 CAMPUS RIDGE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486409533",
            "telephone_number": "989-839-3500",
            "fax_number": "989-839-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301112552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.