Individual provider Active NPI

Jennifer A Zimmerman, D.O.

  • Internal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1477997062
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
078870 Issued in GA
Practice address
1499 Fair Rd
Statesboro, GA 30458-1683
Phone
(304) 424-2111
NPI assigned
Apr 25, 2013
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 078870 GA Primary

Addresses

Primary practice location

1499 Fair Rd
Statesboro, GA 30458-1683

Mailing address

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 486-1973

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.zimmerman@trhs.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803004170 NE Order and Referring Only - Infectious DiseasePractitioner - Infectious Disease 7810215175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
078870GAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jennifer.zimmerman@trhs.cernerdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1477997062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "912-486-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "304-424-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "078870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.zimmerman@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "901 18th St E",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317943648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.