Individual provider Active NPI

William P Zipperer Jr., D.O.

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1306883335
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2291 Issued in AZ
Practice address
1663 E Huber St
Mesa, AZ 85203-3930
Phone
(480) 250-4358
Fax
(480) 962-1746
NPI assigned
May 31, 2006
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2291 AZ Primary

Addresses

Primary practice location

1663 E Huber St
Mesa, AZ 85203-3930

Mailing address

1663 E. Huber St.
Mesa, AZ 85203-3930
Phone (480) 250-4358

Other identifiers 3

IdentifierTypeStateIssuer
AZ0221630OtherAZBCBS
2291OtherAZSTATE LICENSE NUMBER
285032MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2291AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates LTD. Internal Medicine Current Accepting new patients

Locations

4360 E Brown Rd
Ste 114
Mesa, AZ 85205
Phone (480) 964-0080

455 E 4th Pl
Mesa, AZ 85203
Phone (480) 964-0080

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1306883335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 E. HUBER ST.",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033930",
            "telephone_number": "480-250-4358",
            "fax_number": "480-962-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 E HUBER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033930",
            "telephone_number": "480-250-4358",
            "fax_number": "480-962-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIPPERER",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "2291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0221630",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2291",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285032",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.