Individual provider Active NPI

Gretchen Mary Zimmerman, M.D.

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1609861020
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G2253 Issued in TX
Practice address
6624 Fannin St
Suite 2180
Houston, TX 77030-2341
Phone
(713) 797-9500
Fax
(713) 797-9511
NPI assigned
Sep 12, 2005
Reactivated
Mar 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G2253 TX Primary

Addresses

Primary practice location

6624 Fannin St
Suite 2180
Houston, TX 77030-2341

Mailing address

6624 Fannin St
Suite 2180
Houston, TX 77030-2341
Phone (713) 797-9500

Other identifiers 1

IdentifierTypeStateIssuer
097085702MedicaidTX

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1609861020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "SUITE 2180",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302341",
            "telephone_number": "713-797-9500",
            "fax_number": "713-797-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "SUITE 2180",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302341",
            "telephone_number": "713-797-9500",
            "fax_number": "713-797-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "GRETCHEN",
        "middle_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2011-10-12",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G2253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097085702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.