NPIMap

Organization Active NPI

Boone Podiatry PA

  • Primary Podiatric Medicine Podiatrist
  • Boone, NC
National Provider Identifier
1326042979
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
354 Issued in NC
Legal business name
BOONE PODIATRY PA
Practice address
610 State Farm Rd
Ste C
Boone, NC 28607-4738
Phone
(828) 265-3668
NPI assigned
Jun 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Authorized official

Name
Paul Zimmerman, DPM
Title
Podiatrist/ Owner
Phone
(828) 265-3668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X 354 NC Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 354 NC
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X 354 NC

Addresses

Primary practice location

610 State Farm Rd
Ste C
Boone, NC 28607-4738

Mailing address

610 State Farm Rd
Ste C
Boone, NC 28607-4738
Phone (828) 265-3668

Other identifiers 2

IdentifierTypeStateIssuer
0819KOtherNCBCBS
890819KMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1326042979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 STATE FARM RD",
            "address_2": "STE C",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074738",
            "telephone_number": "828-265-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 STATE FARM RD",
            "address_2": "STE C",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074738",
            "telephone_number": "828-265-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE PODIATRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PODIATRIST/ OWNER",
        "authorized_official_telephone_number": "828-265-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "354",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "354",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0819K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890819K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.