Individual provider Active NPI

Robert V Zimmer, D.C.

  • Chiropractor
  • Kettering, OH
National Provider Identifier
1629071519
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
547 Issued in OH
Practice address
2436 E Dorothy LN
Kettering, OH 45420-1155
Phone
(937) 294-1484
Fax
(937) 294-7542
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 547 OH Primary

Addresses

Primary practice location

2436 E Dorothy LN
Kettering, OH 45420-1155

Mailing address

2436 E Dorothy LN
Kettering, OH 45420-1155
Phone (937) 294-1484

Other identifiers 2

IdentifierTypeStateIssuer
310997407-00OtherOHBWC
310997407OtherOHTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091119000065 OH Practitioner - Chiropractic 4587702121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1964
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2436 E Dorothy LN
Kettering, OH 45420-1155
Phone (937) 294-1484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
547OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
R V Zimmer, D.C., Inc Chiropractor CurrentSince Oct 12, 2009 Accepting new patients
Pelle Chiropractic LLC Chiropractor PastSince Nov 13, 2009 Accepting new patients

Locations

2436 E Dorothy Ln
Kettering, OH 45420
Phone (937) 294-1484

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1629071519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 E DOROTHY LN",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454201155",
            "telephone_number": "937-294-1484",
            "fax_number": "937-294-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 E DOROTHY LN",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454201155",
            "telephone_number": "937-294-1484",
            "fax_number": "937-294-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "ROBERT",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "310997407-00",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "310997407",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.