Active NPI
Mark W Zimmerman, M.D.
- Obstetrics & Gynecology Physician
- Raleigh, NC
National Provider Identifier
1669587564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 1104
- Practice address
- 2417 Atrium Dr
Suite 200
Raleigh, NC 27607-6673 - Phone
- (919) 781-9555
- Fax
- (919) 781-1070
- NPI assigned
- Aug 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 1104 | NC | Primary |
Addresses
Primary practice location
2417 Atrium Dr
Suite 200
Raleigh, NC 27607-6673
Mailing address
2417 Atrium Dr
Suite 200
Raleigh, NC 27607-6673
Phone (919) 781-9555
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1199588 | Other | FIRST HEALTH | |
| 4558115 | Other | AETNA | |
| 1568182 | Other | CIGNA | |
| A4026 | Other | MEDCOST | |
| 07-52523 | Other | UNITED HEALTHCARE | |
| 7989860 | Medicaid | NC | |
| 89860 | Other | NC | BCBS OF NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1104 | NC | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rex Hospital, Inc | Past | Accepting new patients | |
| Rex Hospital, Inc. | Past | Accepting new patients |
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.
-
- Pharmacy
- Raleigh, NC
- NPI 1174624803
-
- Nutrition Education Nutritionist
- Raleigh, NC
- NPI 1821472572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669587564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 ATRIUM DR",
"address_2": "SUITE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076673",
"telephone_number": "919-781-9555",
"fax_number": "919-781-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 ATRIUM DR",
"address_2": "SUITE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076673",
"telephone_number": "919-781-9555",
"fax_number": "919-781-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "MARK",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NC",
"license": "1104",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1199588",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4558115",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1568182",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "A4026",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "07-52523",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7989860",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "89860",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
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.