Jeremiah David Zimmerman

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CG61026778 Issued in WA

Practice address

5901 N Lidgerwood St Ste 115
Spokane, WA 99208-1122

Phone

(509) 838-4651

NPI assigned

Dec 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Antonia Tombari and Associates PLLC

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1316530520
  NPD (past)
• Frontier Behavioral Health

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1861495327
  NPD (past)

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1972141273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N LIDGERWOOD ST STE 115",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081122",
            "telephone_number": "509-838-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JEREMIAH",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CG61026778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane A Zim, M.D.
• Joan C Zimmer, ARNP
• Sara C Zimmer, PA
• James Gavin Zimmerman, MD
• Jennifer Zimmerman, RN
• Patricia L Zimmerman, MSN, ARNP
• Raleigh Zimmerman
• Colleen E Zimmermann, MD
• Duane Lewis Zink, O.D.
• Jamie Zinkgraf, BCBA

• Student in an Organized Health Care Education/Training Program in Spokane, WA
• Providers in Spokane, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.