Individual provider Active NPI

Vickie Ann Simon, RN AND LAC

  • Registered Nurse
  • New Iberia, LA
National Provider Identifier
1083644868
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN056527 Issued in LA
Practice address
611 W Admiral Doyle Dr
New Iberia, LA 70560-6408
Phone
(337) 373-0002
Fax
(337) 373-0129
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 793 LA
Registered Nurse 163W00000X RN056527 LA Primary

Addresses

Primary practice location

611 W Admiral Doyle Dr
New Iberia, LA 70560-6408

Mailing address

111 Gauthier Rd
Lafayette, LA 70501-8347
Phone (337) 278-5396

Other names 1

  • Mrs. Vickie Ann Campbell and Fuselier 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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN056527LAMDRegistered Nurse
793LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1083644868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GAUTHIER RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705018347",
            "telephone_number": "337-278-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W ADMIRAL DOYLE DR",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705606408",
            "telephone_number": "337-373-0002",
            "fax_number": "337-373-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "VICKIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN AND LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "793",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN056527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKIE",
            "last_name": "CAMPBELL AND FUSELIER",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "RN AND LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.