Dr Mark M Zimmer PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

01967 Issued in IA

Legal business name

DR MARK M ZIMMER PC

Practice address

12 1St Ave NE
Oelwein, IA 50662-1737

Phone

(319) 283-3155

Fax

(319) 283-3155

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Matthew Zimmer, OD

Title

President

Phone

(319) 283-3155

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Oelwein Family Eyecare Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Dr Mark M Zimmer PC

  • Optometrist
  • Independence, IA
  • NPI 1285700153
  NPPES parent name

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1710078019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 1ST AVE NE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506621737",
            "telephone_number": "319-283-3155",
            "fax_number": "319-283-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 1ST AVE NE",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506621737",
            "telephone_number": "319-283-3155",
            "fax_number": "319-283-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK M ZIMMER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-283-3155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0419432",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08106",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4078170",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oelwein Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Oelwein, IA
• Providers in Oelwein, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.