Active NPI
Gregory Lynn Zimmerman, D.C.
- Chiropractor
- Batavia, IL
National Provider Identifier
1457485906
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 03800924
- Practice address
- 119 S Batavia Ave
Batavia, IL 60510-2450 - Phone
- (630) 482-2214
- Fax
- (630) 879-2347
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 03800924 | IL | Primary |
Addresses
Primary practice location
119 S Batavia Ave
Batavia, IL 60510-2450
Mailing address
119 S Batavia Ave
Batavia, IL 60510-2450
Phone (630) 482-2214
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09123588 | Other | IL | BLUE CROSS BLUE SHIELD IL |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03800924 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1457485906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 S BATAVIA AVE",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605102450",
"telephone_number": "630-482-2214",
"fax_number": "630-879-2347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 S BATAVIA AVE",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605102450",
"telephone_number": "630-482-2214",
"fax_number": "630-879-2347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "GREGORY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "03800924",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IL",
"identifier": "09123588",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batavia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.