Spencer Zimmerman, DC, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11033905 Issued in FL

Practice address

2404 Creel LN Ste 101
Wesley Chapel, FL 33544-4606

Phone

(813) 838-4005

NPI assigned

Jun 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 12, 2018 through Jul 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Functional Medicine Center of Boise LLC

  • Primary Care Clinic/Center
  • Nampa, ID
  • NPI 1710477310
  NPD Authorized official

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1568844975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32532 SAPNA CHIME DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335455393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 CREEL LN STE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335444606",
            "telephone_number": "813-838-4005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1678 S Woodsage Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428325",
            "country_code": "US",
            "telephone_number": "208-550-2380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "DC, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "ID",
            "license": "59038",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1864",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "15222",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "59038",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Zambito, DPT
• Abigail Leonor Zamora, PA-C
• Stephanie Zamudio, RD, LDN
• Carmen Zayas-Aiken, PHARMD.
• Zeid Zeidan, MD
• Amber Zooberg
• Theresa J Zorn, NP
• Joelle Cynthia Zourob
• Zubair Farooqui MD LLC
• Carol Zukosky, SLP

• Family Nurse Practitioner in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.