Individual provider Active NPI

Beth Marie Zimmerman, M S

  • Audiologist
  • Fort Wayne, IN
National Provider Identifier
1326080284
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23001905A Issued in IN
Practice address
10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone
(260) 426-8117
Fax
(260) 420-0817
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23001905A IN Primary
Audiologist 231H00000X 3551 NC

Addresses

Primary practice location

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604

Mailing address

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone (260) 426-8117

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
Master of Science

State licenses

LicenseStateTypeSpecialty
23001905AINMDAudiologist
3551NCMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1326080284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "BETH",
        "middle_name": "MARIE",
        "credential": "M S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23001905A",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "3551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.