Nathan Zimmerman

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2398 Issued in WY

Practice address

1175 S Hwy 89 Ste a
Jackson, WY 83001-8512

Phone

(307) 733-5577

NPI assigned

Jun 5, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, AZ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
  • NPI 1285295089

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Four Pines Physical Therapy Limited Partnership

  • Physical Therapist
  • Jackson, WY
  • NPI 1578373890
  Medicare reassignment NPD
• Four Pines Physical Therapy PC

  • Physical Therapist
  • Jackson, WY
  • NPI 1013090539
  Medicare reassignment NPD
• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1609662709
  NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1326889171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13213",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830023213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 S HWY 89 STE A",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018512",
            "telephone_number": "307-733-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "2398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Yourk
• Ariel Zablocki
• Rebecca Zalewski
• Jennifer Zalta, NCTMB
• John William Zendler, DC

• Physical Therapist in Jackson, WY
• Providers in Jackson, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.