Individual provider Active NPI

Donielle M. Zimmerman, P.A.-C

  • Surgical Physician Assistant
  • Greensboro, NC
National Provider Identifier
1336147768
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
102812 Issued in NC
Practice address
301 E Wendover Ave
Suite 411
Greensboro, NC 27401-1230
Phone
(336) 832-3200
Fax
(336) 832-3201
NPI assigned
Jul 11, 2005
Last updated
Dec 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101135 FL
Surgical Physician Assistant 363AS0400X 102812 NC Primary

Addresses

Primary practice location

301 E Wendover Ave
Suite 411
Greensboro, NC 27401-1230

Mailing address

1200 N Elm St
Suite 411
Greensboro, NC 27401-1004
Phone (336) 832-3200

Other identifiers 2

IdentifierTypeStateIssuer
E3461OtherFLBCBS
290763100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000242 NC Practitioner - Physician Assistant 5496850752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

1200 N Elm St
Greensboro, NC 27401-1020

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102812NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Apr 28, 2025 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Apr 28, 2025 Accepting new patients
Stuart Cardiovascular Associates, PLLC PastSince Jul 31, 2006 Accepting new patients
Treasure Coast Surgical Group Past Accepting new patients
Stuart Cardiovascular Anesthesia Associates PLLC PastSince Jul 31, 2006 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1200 N Elm St
Ste 411
Greensboro, NC 27401

300 E Wendover Ave
Fl 2
Greensboro, NC 27401
Phone (336) 663-5219

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1336147768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ELM ST",
            "address_2": "SUITE 411",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011004",
            "telephone_number": "336-832-3200",
            "fax_number": "336-832-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE",
            "address_2": "SUITE 411",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011230",
            "telephone_number": "336-832-3200",
            "fax_number": "336-832-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "DONIELLE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101135",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "102812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "E3461",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290763100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.