Active NPI
Kyle Isaac Zimmerman, ATC
- Athletic Trainer
- Boiling Springs, NC
National Provider Identifier
1598105322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 110 S Main St
Boiling Springs, NC 28017-9797 - Phone
- (704) 406-4000
- NPI assigned
- Jun 25, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | NC | Primary | |
| Athletic Trainer | 2255A2300X | AT001917 | GA |
Addresses
Primary practice location
110 S Main St
Boiling Springs, NC 28017-9797
Mailing address
1635 S Dekalb St
516
Shelby, NC 28152-8768
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 |
|---|---|---|---|
| AT001917 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1598105322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 S DEKALB ST",
"address_2": "516",
"city": "SHELBY",
"state": "NC",
"postal_code": "281528768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S MAIN ST",
"city": "BOILING SPRINGS",
"state": "NC",
"postal_code": "280179797",
"telephone_number": "704-406-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "KYLE",
"middle_name": "ISAAC",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": null,
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT001917",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boiling Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.