Individual provider Active NPI

Cherelle Renee Simmons Chin, SLPD CCC-SLP

  • Speech-Language Pathologist
  • Lehigh Acres, FL
National Provider Identifier
1053710103
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3509 32ND St SW
Lehigh Acres, FL 33976-4367
Phone
(215) 678-9867
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

3509 32ND St SW
Lehigh Acres, FL 33976-4367

Mailing address

3509 32ND St SW
Lehigh Acres, FL 33976-4367
Phone (215) 678-9867

Other practice location 1

401 N 9th St
Immokalee, FL 34142-3104
Phone (239) 377-4200

Other identifiers 1

IdentifierTypeStateIssuer
105983200MedicaidFL

Other names 1

  • Dr. Cherelle Simmons Former name

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherelle R. Simmons P.a. CurrentSince Apr 6, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1053710103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 32ND ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339764367",
            "telephone_number": "215-678-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 32ND ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339764367",
            "telephone_number": "215-678-9867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Immokalee",
            "state": "FL",
            "postal_code": "341423104",
            "country_code": "US",
            "telephone_number": "239-377-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS CHIN",
        "first_name": "CHERELLE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "SLPD CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105983200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERELLE",
            "last_name": "SIMMONS",
            "prefix": "DR.",
            "credential": "SLPD CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.