Individual provider Active NPI

Parker L Simon, D.O., M.P.H.

  • Neonatal-Perinatal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1093855066
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
4227 Issued in OK
Practice address
1120 S Utica Ave
Suite 2123
Tulsa, OK 74104
Phone
(918) 579-5402
Fax
(918) 579-5404
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 4227 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Suite 2123
Tulsa, OK 74104

Mailing address

1120 S Utica Ave Ste 2123
Tulsa, OK 74104-4012
Phone (918) 579-5402

Other practice location 1

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-6428

Other practice location 2

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-6428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191114001954 MO Practitioner - Pediatric MedicinePractitioner - Other (Physician) 6305092743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4227OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince Oct 1, 2019 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
Ahs Southcrest Hospital, LLC Past Accepting new patients
Newborn Specialists of Tulsa, P.C. Neonatal-Perinatal Medicine Past Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1120 S Utica Ave
Ste 2123
Tulsa, OK 74104
Phone (918) 579-5402

Organizations & group practices 5

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1093855066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE STE 2123",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-5402",
            "fax_number": "918-579-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "address_2": "SUITE 2123",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-579-5402",
            "fax_number": "918-579-5404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mercy Way",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "64804",
            "country_code": "US",
            "telephone_number": "417-556-6428",
            "fax_number": "417-556-6429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Mercy Way",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "64804",
            "country_code": "US",
            "telephone_number": "417-556-6428",
            "fax_number": "417-556-6429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "PARKER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "4227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.