Individual provider Active NPI

Neil Simmons, O.D.

  • Optometrist
  • Carthage, MS
National Provider Identifier
1104937556
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
563 Issued in MS
Practice address
110 N Van Buren St
Carthage, MS 39051-4126
Phone
(601) 267-7777
Fax
(601) 267-7774
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 563 MS Primary
Corneal and Contact Management Optometrist 152WC0802X 563 MS
Occupational Vision Optometrist 152WX0102X 563 MS
Pediatric Optometrist 152WP0200X 563 MS
Sports Vision Optometrist 152WS0006X 563 MS

Addresses

Primary practice location

110 N Van Buren St
Carthage, MS 39051-4126

Mailing address

110 N Van Buren St
Carthage, MS 39051-4126
Phone (601) 267-7777

Other identifiers 1

IdentifierTypeStateIssuer
00880215MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080714000154 MS Practitioner - Optometry 1951473644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
563MSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Eye Care, PA Optometrist CurrentSince Apr 17, 2023 Accepting new patients
Ms Eye Care PA Optometrist CurrentSince Apr 17, 2023 Accepting new patients

Locations

110 N Van Buren St
Carthage, MS 39051
Phone (601) 267-7772

5002 Highway 39 N
Bldg B
Meridian, MS 39301
Phone (601) 483-7331

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1104937556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N VAN BUREN ST",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390514126",
            "telephone_number": "601-267-7777",
            "fax_number": "601-267-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N VAN BUREN ST",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390514126",
            "telephone_number": "601-267-7777",
            "fax_number": "601-267-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "563",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MS",
            "license": "563",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "MS",
            "license": "563",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MS",
            "license": "563",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "MS",
            "license": "563",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880215",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MS

Sources for this page

Verify at the official NPI Registry.