Clinton Ballard Zimmerman Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34214 Issued in NC

Practice address

579 Greenway Rd
Suite 200
Boone, NC 28607-4809

Phone

(828) 262-0100

Fax

(828) 264-7592

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: clintonzimmerman@brpami.allscriptsdirect.net
• Direct secure messaging: czimmerman@brpedsadolmed.trimed.direct-ci.com

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

• Blue Ridge Pediatric & Adolescent Medicine, Inc

  • Pediatrics Physician
  • Boone, NC
  • NPI 1114038163
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1861483539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 GREENWAY RD",
            "address_2": "SUITE 200",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074809",
            "telephone_number": "828-262-0100",
            "fax_number": "828-264-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 GREENWAY RD",
            "address_2": "SUITE 200",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074809",
            "telephone_number": "828-262-0100",
            "fax_number": "828-264-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CLINTON",
        "middle_name": "BALLARD",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "34214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "62308-NOCD",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "8991E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYEES",
            "identifier": "8991E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "12-71030",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "72758",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "898991E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC HEALTH CHOICE",
            "identifier": "8991E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH PLAN",
            "identifier": "8991E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Young, AU.D.
• Morgan Younger, RBT
• Ashley Yow
• Jessica Zerkle
• Martina Ziegenbein, M.D.
• Joan Marjorie Zimmerman, LMFT
• Paul P Zimmerman, DPM
• Rachel Mae Zuniga, PT, DPT

• Pediatrics Physician in Boone, NC
• Providers in Boone, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.