Active NPI
Robert Zimmerman
- Massage Therapist
- Bend, OR
National Provider Identifier
1477093227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 28496
- Practice address
- 628 NW York Dr Ste 205
Bend, OR 97703-1572 - Phone
- (541) 728-3911
- NPI assigned
- Feb 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Massage Therapist | 225700000X | 28496 | OR | Primary |
Addresses
Primary practice location
628 NW York Dr Ste 205
Bend, OR 97703-1572
Mailing address
1853 NW Monterey Pines Dr
Bend, OR 97703-5669
Phone (603) 677-6868
Other practice location 1
11260 Donner Pass Rd
Box 435
Truckee, CA 96161-4848
Phone (603) 677-6868
Other practice location 2
628 NW York Dr Ste 205
Bend, OR 97703-1572
Phone (541) 728-3911
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28496 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bruann Harmony, LLC | Current | Accepting new patients |
Locations
628 NW York Dr
Ste 205
Bend, OR 97703
Phone (541) 728-3911
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.
-
- Physical Therapy Clinic/Center
- Bend, OR
- NPI 1386437135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1477093227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1853 NW MONTEREY PINES DR",
"city": "BEND",
"state": "OR",
"postal_code": "977035669",
"telephone_number": "603-677-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 NW YORK DR STE 205",
"city": "BEND",
"state": "OR",
"postal_code": "977031572",
"telephone_number": "541-728-3911"
}
],
"practiceLocations": [
{
"address_1": "11260 Donner Pass Rd",
"address_2": "Box 435",
"address_purpose": "LOCATION",
"city": "Truckee",
"state": "CA",
"postal_code": "961614848",
"country_code": "US",
"telephone_number": "603-677-6868",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "628 NW York Dr Ste 205",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977031572",
"country_code": "US",
"telephone_number": "541-728-3911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "ROBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-27",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "28496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.