Miranda Lynn Zimmerman, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT8216 Issued in TX

Practice address

13082 Centerfield Drive
Suite 200
Houston, TX 77070

Phone

(281) 737-0999

NPI assigned

May 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1790359776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 WILLOW CHASE BLVD APT 1033",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770706806",
            "telephone_number": "248-660-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13082 CENTERFIELD DRIVE",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77070",
            "telephone_number": "281-737-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MIRANDA",
        "middle_name": "LYNN",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "9101003777",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zimme1ml@cmich.edu",
            "affiliation": "Y",
            "affiliationName": "CENTRAL MICHIGAN UNIVERSITY",
            "address_1": "1101 Health Professions Bldg",
            "address_2": "STE 2105",
            "city": "MT Pleasant",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488590001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cortney Taylor Zimmerman, PH.D.
• Geoffrey Andrew Zimmerman, M.D.
• Gretchen Mary Zimmerman, M.D.
• Janice Zimmerman, MD
• Jeremy Zimmerman, MD
• Patrick James Zimmerman Jr., MD
• Stanley Jay Zimmerman, M.D.
• Kate Zimmermann, APRN
• Kuno Peter Zimmermann, D.O.
• Shireen Zindani, M.D

• Athletic Trainer in Houston, TX
• Providers in Houston, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.