Organization Active NPI

Johnnie Mae Simmons

  • Pediatric Skilled Nursing Facility
  • Milwaukee, WI
National Provider Identifier
1023367612
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
167452 Issued in WI
Legal business name
JOHNNIE MAE SIMMONS
Practice address
4560 N. 40TH St,
Milwaukee, WI 53209
Phone
(414) 510-4893
NPI assigned
Aug 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Ms. Johnnie Mae Simmons, REGISTERED NURSINGNPI 1184853012
Title
Register Nursing
Phone
(414) 510-4893

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 167452 WI Primary

Addresses

Primary practice location

4560 N. 40TH St,
Milwaukee, WI 53209

Mailing address

4560 N. 40TH St,
Milwaukee, WI 53209
Phone (414) 510-4893

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1023367612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 N. 40TH ST,",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-510-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 N. 40TH ST,",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-510-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNNIE MAE SIMMONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "JOHNNIE MAE",
        "authorized_official_title_or_position": "REGISTER NURSING",
        "authorized_official_telephone_number": "414-510-4893",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "REGISTERED NURSING"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "WI",
            "license": "167452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.