Active NPI
Edward Calvin Simpson, CSA
- Surgical Technologist
- La Plata, MD
National Provider Identifier
1093706228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- Practice address
- 4850 Brierwood Rd
La Plata, MD 20646-5602 - Phone
- (301) 392-1177
- Fax
- (301) 392-1177
- NPI assigned
- Nov 5, 2005
- Last updated
- Nov 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | NU | Primary |
Addresses
Primary practice location
4850 Brierwood Rd
La Plata, MD 20646-5602
Mailing address
PO Box 277
Pomfret, MD 20675-0277
Phone (301) 752-1578
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 521800757 | Other | FED TAX I.D. # |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1093706228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 277",
"city": "POMFRET",
"state": "MD",
"postal_code": "206750277",
"telephone_number": "301-752-1578",
"fax_number": "301-392-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 BRIERWOOD RD",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206465602",
"telephone_number": "301-392-1177",
"fax_number": "301-392-1177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPSON",
"first_name": "EDWARD",
"middle_name": "CALVIN",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-05",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX I.D. #",
"identifier": "521800757",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in La Plata, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.