Individual provider Active NPI

Donna Ellen Simmons, MS, CCC-SPL

  • Speech-Language Pathologist
  • St Elizabeth, MO
National Provider Identifier
1063765550
Registry record updated Oct 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
117825 Issued in MO
Practice address
649 S Walnut St
Saint Elizabeth, MO 65075-2440
Phone
(573) 493-2215
NPI assigned
Oct 21, 2012
Last updated
Oct 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2012

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 117825 MO Primary

Addresses

Primary practice location

649 S Walnut St
Saint Elizabeth, MO 65075-2440

Mailing address

3605 County Road 4022
Holts Summit, MO 65043-1924
Phone (573) 295-4381

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
117825MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350777600000",
    "number": "1063765550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 COUNTY ROAD 4022",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650431924",
            "telephone_number": "573-295-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 S WALNUT ST",
            "city": "SAINT ELIZABETH",
            "state": "MO",
            "postal_code": "650752440",
            "telephone_number": "573-493-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DONNA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SPL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-21",
        "last_updated": "2012-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "117825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Elizabeth, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.