Active NPI
Lawrence Joseph Zimmer, MD
- Psychiatry Physician
- Fort Gratiot, MI
National Provider Identifier
1588846604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301030679
- Practice address
- 1501 Krafft Rd
Fort Gratiot, MI 48059-3565 - Phone
- (810) 985-5125
- Fax
- (810) 985-5127
- NPI assigned
- Nov 30, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301030679 | MI | Primary |
Addresses
Primary practice location
1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Mailing address
1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z10656511 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274745600000",
"number": "1588846604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 KRAFFT RD",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593565",
"telephone_number": "810-985-5125",
"fax_number": "810-985-5127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 KRAFFT RD",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593565",
"telephone_number": "810-985-5125",
"fax_number": "810-985-5127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMER",
"first_name": "LAWRENCE",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-30",
"last_updated": "2010-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301030679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z10656511",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Gratiot, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.