Individual provider Active NPI

Kim Simmons, FNP-C

  • Nurse Practitioner
  • Sayre, PA
National Provider Identifier
1083147946
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP017370 Issued in PA
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 887-2845
Fax
(570) 887-2011
NPI assigned
Apr 7, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017370 PA Primary
Family Nurse Practitioner 363LF0000X SP017370 PA

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other practice location 1

54 Bly Rd
Pine City, NY 14871-9568
Phone (607) 733-6010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180205000358 PA Practitioner - Nurse Practitioner 3870853203 Reassigns benefits to 1 organization
I20180410000037 NY Practitioner - Nurse Practitioner 3870853203 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone (607) 444-6868

243 Maple Ave
Wellsville, NY 14895-1114
Phone (585) 593-7246

244 W Water St
Suite 105
Elmira, NY 14901-2926
Phone (607) 203-8709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP017370PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delphi Healthcare PLLC Nurse Practitioner CurrentSince Aug 1, 2019 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Feb 11, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jan 15, 2018 Accepting new patients
Neurosciences Healthcare Medicine, PC CurrentSince Dec 31, 2024 Accepting new patients
Neurosciences Healthcare Medicine, PC CurrentSince Dec 31, 2024 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jan 15, 2018 Accepting new patients
Delphi Hospitalist Services LLC CurrentSince Aug 1, 2019 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients

Locations

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

122 W Main St
Endicott, NY 13760
Phone (607) 237-4724

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

1020 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 444-6868

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJEFCD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083147946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-2845",
            "fax_number": "570-887-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Bly Rd",
            "address_purpose": "LOCATION",
            "city": "Pine City",
            "state": "NY",
            "postal_code": "148719568",
            "country_code": "US",
            "telephone_number": "607-733-6010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KIM",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017370",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017370",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

Verify at the official NPI Registry.