Individual provider Active NPI

Jeffrey John Zimmerman, P.T.

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1396963815
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1507 Issued in NE
Practice address
2728 N 108TH St Ste 103
Omaha, NE 68164-3763
Phone
(402) 939-7939
Fax
(402) 939-7940
NPI assigned
Apr 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 1507 NE
Orthopedic Physical Therapist 2251X0800X 1507 NE
Physical Therapist 225100000X 1507 NE Primary

Addresses

Primary practice location

2728 N 108TH St Ste 103
Omaha, NE 68164-3763

Mailing address

3405 S 117TH St
Omaha, NE 68144-4642
Phone (402) 981-1407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000844 NE Practitioner - Physical Therapist in Private Practice 9234208877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15767 C W Hadan Dr
Bennington, NE 68007-2015
Phone (402) 238-2552

2728 N 108TH St
Suite 103
Omaha, NE 68164-3763
Phone (402) 939-7939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1507NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients

Locations

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

15767 Hadan Dr
Bennington, NE 68007
Phone (402) 238-2552

2728 N 108th St
Ste 103
Omaha, NE 68164
Phone (402) 939-7939

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1396963815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 S 117TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444642",
            "telephone_number": "402-981-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 N 108TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643763",
            "telephone_number": "402-939-7939",
            "fax_number": "402-939-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NE",
            "license": "1507",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NE",
            "license": "1507",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.