Individual provider Active NPI

Robert A Simmons, MD

  • Gastroenterology Physician
  • Fort Collins, CO
National Provider Identifier
1023114832
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
22917 Issued in CO
Practice address
3702 S Timberline Rd
Fort Collins, CO 80525-3624
Phone
(970) 207-9773
Fax
(970) 207-1893
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 22917 CO Primary
Gastroenterology Physician 207RG0100X 8372A WY

Addresses

Primary practice location

3702 S Timberline Rd
Fort Collins, CO 80525-3624

Mailing address

3702 S Timberline Rd
Fort Collins, CO 80525-3624
Phone (970) 207-9773

Other identifiers 2

IdentifierTypeStateIssuer
01229178MedicaidCO
826103111OtherCOMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22917COMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1023114832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-207-9773",
            "fax_number": "970-207-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-207-9773",
            "fax_number": "970-207-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "22917",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WY",
            "license": "8372A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01229178",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "826103111",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.