Individual provider Active NPI

Michael Bernard Zimmer, M.D.

  • Specialist
  • Vero Beach, FL
National Provider Identifier
1710148309
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21582 Issued in FL
Practice address
214 Rudder Rd
Vero Beach, FL 32963-2934
Phone
(772) 559-0223
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 21582 FL Primary

Addresses

Primary practice location

214 Rudder Rd
Vero Beach, FL 32963-2934

Mailing address

214 Rudder Rd
Vero Beach, FL 32963-2934
Phone (772) 559-0223

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21582FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1710148309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 RUDDER RD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632934",
            "telephone_number": "772-559-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 RUDDER RD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632934",
            "telephone_number": "772-559-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "MICHAEL",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "21582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.