NPIMap

Individual provider Active NPI

Nicole Denise Zimmerman, D.O.

  • Family Medicine Physician
  • Ephrata, PA
National Provider Identifier
1730151093
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 010476 L Issued in PA
Practice address
44 Lancaster Ave
Ephrata, PA 17522-1700
Phone
(717) 738-2468
Fax
(717) 738-9936
NPI assigned
Feb 2, 2006
Last updated
Sep 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS 010476 L PA Primary

Addresses

Primary practice location

44 Lancaster Ave
Ephrata, PA 17522-1700

Mailing address

44 Lancaster Ave
Ephrata, PA 17522-1700
Phone (717) 738-2468

Other names 1

  • Nicole Denise Weaver Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303001075 PA Practitioner - Family Practice 8628113560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

101 Larkspur LN
Ephrata, PA 17522-8402
Phone (717) 569-5331

1261 Division Hwy
Ephrata, PA 17522-8822

1261 Division Hwy 2
Ephrata, PA 17522-8822
Phone (717) 738-5544

1701 Cornwall Rd
Lebanon, PA 17042-7480

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 010476 LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Jun 19, 2017 Accepting new patients
Lancaster General Medical Group Family Medicine CurrentSince Jun 19, 2017 Accepting new patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group Family Medicine Past Accepting new patients

Locations

1635 W Main St
Ste 700
Ephrata, PA 17522
Phone (717) 738-0660

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1730151093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 LANCASTER AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221700",
            "telephone_number": "717-738-2468",
            "fax_number": "717-738-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 LANCASTER AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221700",
            "telephone_number": "717-738-2468",
            "fax_number": "717-738-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "NICOLE",
        "middle_name": "DENISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS 010476 L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WEAVER",
            "middle_name": "DENISE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.