Healthcare Provider Details

I. General information

NPI: 1700950300
Provider Name (Legal Business Name): JAMES ZIMMERMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ROBERTSON AVE STE 2
CINCINNATI OH
45209-1267
US

IV. Provider business mailing address

1430 OAK CT STE 100
BEAVERCREEK OH
45430-1064
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-4400
  • Fax: 513-281-4832
Mailing address:
  • Phone: 937-404-1101
  • Fax: 937-404-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.000780RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: