Individual provider Active NPI

Michelle R Zimmerman, MD

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1982645909
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35085900 Issued in OH
Practice address
1930 Crown Park CT
Columbus, OH 43235-2402
Phone
(614) 457-1793
Fax
(614) 457-0704
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 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 35085900 OH Primary

Addresses

Primary practice location

1930 Crown Park CT
Columbus, OH 43235-2402

Mailing address

1930 Crown Park CT
Columbus, OH 43235-2402
Phone (614) 457-1793

Other identifiers 1

IdentifierTypeStateIssuer
2653123MedicaidOH

Other names 1

  • Michelle Rae Zimmerman Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060801000003 OH Practitioner - Family Practice 5294748604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4100 Horizons Dr
Suite 100
Columbus, OH 43220-5280
Phone (614) 457-1793

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

4885 Olentangy River Rd
Columbus, OH 43214-1953

4885 Olentangy River Rd
Columbus, OH 43214-1993

4895 Olentangy River Rd
Columbus, OH 43214-1185

625 Africa Rd
Westerville, OH 43082-0002

8050 E Main St
Suite 1200
Reynoldsburg, OH 43068-2575
Phone (614) 259-0923

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Family Medicine CurrentSince Apr 18, 2012 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Apr 18, 2012 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4100 Horizons Dr
Ste 100
Columbus, OH 43220
Phone (614) 457-1793

1930 Crown Park Ct
Columbus, OH 43235
Phone (614) 326-0146

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Interoperability endpoints

  • Direct secure messaging: mzimmerman18754@copcp.medicity.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1982645909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352402",
            "telephone_number": "614-457-1793",
            "fax_number": "614-457-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352402",
            "telephone_number": "614-457-1793",
            "fax_number": "614-457-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35085900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2653123",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ZIMMERMAN",
            "middle_name": "RAE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.