Active NPI
Haley Zimmer, DPT
- Physical Therapist
- Mountain Grove, MO
National Provider Identifier
1780147686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2019018678
- Practice address
- 1206 N Main St
Mountain Grove, MO 65711-1025 - Phone
- (417) 926-5699
- Fax
- (417) 926-5703
- NPI assigned
- Apr 9, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2019018678 | MO | Primary |
Addresses
Primary practice location
1206 N Main St
Mountain Grove, MO 65711-1025
Mailing address
8843 Mountain Valley Rd
Mountain Grove, MO 65711-2352
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019018678 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1780147686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8843 MOUNTAIN VALLEY RD",
"city": "MOUNTAIN GROVE",
"state": "MO",
"postal_code": "657112352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 N MAIN ST",
"city": "MOUNTAIN GROVE",
"state": "MO",
"postal_code": "657111025",
"telephone_number": "417-926-5699",
"fax_number": "417-926-5703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMER",
"first_name": "HALEY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-09",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2019018678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Grove, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.