Individual provider Active NPI

Wayne Zimmerman, PT

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1417272220
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT30915 Issued in FL
Practice address
3800 Sawgrass Way Apt 3113
Naples, FL 34112-3379
Phone
(312) 545-3217
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT30915 FL Primary
Physical Therapist 225100000X 070017043 IL

Addresses

Primary practice location

3800 Sawgrass Way Apt 3113
Naples, FL 34112-3379

Mailing address

3800 Sawgrass Way Apt 3113
Naples, FL 34112-3379
Phone (312) 545-3217

Other practice location 1

16170 S. Kingsport Rd.
Orland Park, IL 60467-5602
Phone (708) 326-1550

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT30915FLMDPhysical Therapist
070017043ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Therapy & Consultation, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1417272220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SAWGRASS WAY APT 3113",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341123379",
            "telephone_number": "312-545-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SAWGRASS WAY APT 3113",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341123379",
            "telephone_number": "312-545-3217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16170 S. Kingsport Rd.",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604675602",
            "country_code": "US",
            "telephone_number": "708-326-1550",
            "fax_number": "708-326-1557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "WAYNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30915",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.