Justin Simm

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

TL368247 Issued in OH

Practice address

146 Lindy Lane Ave NW
North Canton, OH 44720-2762

Phone

(330) 417-8576

NPI assigned

Oct 28, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1114322492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 LINDY LANE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202762",
            "telephone_number": "330-417-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 LINDY LANE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202762",
            "telephone_number": "330-417-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMM",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "TL368247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca S Sibert
• Anna Sibeto, COTA/L
• Aleta M Sieger
• Allison Sigman, WHNP-BC, MSN, RN
• Victor Silea, RPH.
• Ellen A Simon, PTA
• Amaris Danielle Simonson, COTAL
• Leah Lynn Simpson
• Dorothy Singer
• Sharon Denise Singletary, COTA

• Athletic Trainer in North Canton, OH
• Providers in North Canton, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.