Active NPI
Peter Lawrence Zimmer, MA
- Counselor
- Enfield, CT
National Provider Identifier
1639221286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 000346
- Practice address
- 139 Hazard Ave
Suite 5
Enfield, CT 06082-4585 - Phone
- (860) 324-1617
- Fax
- (860) 749-5335
- NPI assigned
- Jan 16, 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 000346 | CT | Primary |
Addresses
Primary practice location
139 Hazard Ave
Suite 5
Enfield, CT 06082-4585
Mailing address
139 Hazard Ave
Suite 5
Enfield, CT 06082-4585
Phone (860) 324-1617
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000346 | CT | MD | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639221286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 HAZARD AVE",
"address_2": "SUITE 5",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824585",
"telephone_number": "860-324-1617",
"fax_number": "860-749-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 HAZARD AVE",
"address_2": "SUITE 5",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824585",
"telephone_number": "860-324-1617",
"fax_number": "860-749-5335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMER",
"first_name": "PETER",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "000346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.