Active NPI
Gary F Zimmerman, DC
- Chiropractor
- Pendleton, OR
National Provider Identifier
1710073465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1266
- Practice address
- 409 SW 4TH St
Ste a
Pendleton, OR 97801-2068 - Phone
- (541) 276-1097
- Fax
- (541) 966-9713
- NPI assigned
- Oct 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1266 | OR | Primary |
Addresses
Primary practice location
409 SW 4TH St
Ste a
Pendleton, OR 97801-2068
Mailing address
PO Box 186
Pendleton, OR 97801-0186
Phone (541) 276-8276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120215000609 | OR | Practitioner - Chiropractic | 8224296504 | Practice locations: Pendleton, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710073465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 186",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010186",
"telephone_number": "541-276-8276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 SW 4TH ST",
"address_2": "STE A",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978012068",
"telephone_number": "541-276-1097",
"fax_number": "541-966-9713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "GARY",
"middle_name": "F",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "1266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, OR
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.