Active NPI
Daniel James Zimmerman, PA-C
- Physician Assistant
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 102464
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (910) 667-5830
- Fax
- (910) 815-5698
- NPI assigned
- Jun 30, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00744 | OR | |
| Physician Assistant | 363A00000X | 4558 | OK | |
| Physician Assistant | 363A00000X | 102464 | NC | Primary |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 667-5830
Other practice location 1
920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104-5036
Phone (405) 271-4351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-5105
231 S 17TH St
Wilmington, NE 28401-7407
Phone (910) 667-5105
800 Jefferson St
Suite 112
Whiteville, NC 28472-3702
Phone (910) 662-9500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4841 | AZ | MD | Chiropractor |
| 4558 | OK | MD | Speech-Language Pathologist |
| 102464 | NC | MD | Physician Assistant |
| PA00744 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group Coastal Region, LLC | Current | Accepting new patients | |
| NMG Health Services LLC | Current | Accepting new patients | |
| Firstcare Medical Foundation | Physician Assistant | Past | Accepting new patients |
| Good Samaritan Hospital Corvallis | Past | Accepting new patients | |
| New Hanover Medical Group PA | Past | Accepting new patients |
Locations
800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164
2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000
Interoperability endpoints
- dzimmermancontractstaff157962@samhealth.direct-ci.com
- dzimmerman1469432@direct.novanthealth.org
Organizations & group practices 7
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.
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1649865791
-
- Clinic/Center
- Springfield, OR
- NPI 1730734161
-
- Maternal & Fetal Medicine Physician
- Bolivia, NC
- NPI 1558242495
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1306618053
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1992751374
-
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
Physician Assistant
-
- Durable Medical Equipment & Medical Supplies
- Corvallis, OR
- NPI 1477851186
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1598793036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936857",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311936857",
"telephone_number": "910-667-5830",
"fax_number": "910-815-5698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "910-667-5830",
"fax_number": "910-815-5698"
}
],
"practiceLocations": [
{
"address_1": "920 Stanton L Young Blvd # Wp1140",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731045036",
"country_code": "US",
"telephone_number": "405-271-4351",
"fax_number": "405-271-8695",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "DANIEL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA00744",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "4558",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "102464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.