Shawn Patrick Simmons, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 2173 Issued in AR

Practice address

451 W Locke St
Ashdown, AR 71822-3325

Phone

(870) 898-4115

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1104030675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 LITTLE RIVER 17",
            "city": "ASHDOWN",
            "state": "AR",
            "postal_code": "718229455",
            "telephone_number": "870-898-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 W LOCKE ST",
            "city": "ASHDOWN",
            "state": "AR",
            "postal_code": "718223325",
            "telephone_number": "870-898-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 2173",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1096923",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145189721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Russell, APRN
• Lynda Gail Russell, APN
• Ashley Renee Sanders, MS CCC/SLP
• Serenity Hospice, LLC
• Candice Settlemoir, COTA
• Alicia Smith-Block
• Southern Grace Healthcare Inc.
• Southwest Arkansas Counseling and Mental Health Center, Inc
• Kelsey Starks, M.S. CCC-SLP
• State of Arkansas

• All providers in Ashdown, AR
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.