Active NPI
Edward F Zimmer, M.A.
- Psychologist
- Hillsborough, NC
National Provider Identifier
1700082583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2241
- Practice address
- 2601 Hooper CT
Hillsborough, NC 27278-8993 - Phone
- (919) 732-4432
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2241 | NC | Primary |
| Clinical Psychologist | 103TC0700X | 2241 | NC | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2241 | NC | |
| School Psychologist | 103TS0200X | 2241 | NC |
Addresses
Primary practice location
2601 Hooper CT
Hillsborough, NC 27278-8993
Mailing address
2601 Hooper CT
Hillsborough, NC 27278-8993
Phone (919) 732-4432
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107035 | Medicaid | NC | |
| 04580 | Other | NC | BCBS PROVIDER NO. |
| 149737 | Other | NC | VALUE OPTIONS PROVIDER NO |
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 |
|---|---|---|---|
| 2241 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391990400000",
"number": "1700082583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 HOOPER CT",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272788993",
"telephone_number": "919-732-4432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 HOOPER CT",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272788993",
"telephone_number": "919-732-4432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMER",
"first_name": "EDWARD",
"middle_name": "F",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2014-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2241",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2241",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "2241",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NC",
"license": "2241",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107035",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NO.",
"identifier": "04580",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER NO",
"identifier": "149737",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsborough, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.