Randall Zimmerman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

32213 Issued in CA

Practice address

5100 Obyrnes Ferry Rd
Jamestown, CA 95327-9102

Phone

(209) 984-5291

Fax

(209) 984-0151

NPI assigned

Nov 9, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Jamestown, CA
  • NPI 1871898304
  NPD (past)
• Sierra Conservation Center

  • Adult Mental Health Clinic/Center
  • Jamestown, CA
  • NPI 1710427778
  NPD (past)

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1356521041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 OBYRNES FERRY RD",
            "city": "JAMESTOWN",
            "state": "CA",
            "postal_code": "953279102",
            "telephone_number": "209-984-5291",
            "fax_number": "209-984-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 OBYRNES FERRY RD",
            "city": "JAMESTOWN",
            "state": "CA",
            "postal_code": "953279102",
            "telephone_number": "209-984-5291",
            "fax_number": "209-984-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "RANDALL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "32213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Leann Townsend, IBCLC
• Gina M Valente-Moore, FNP
• Chantell Weir, FNP
• Courtney Wiseman, PA
• David Wormhood, DDS

• All providers in Jamestown, CA
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.