Active NPI
Leslie Annette Simmons, LPN
- Licensed Practical Nurse
- Fayetteville, NC
National Provider Identifier
1114497393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 51264
- Practice address
- 500 Grouper Dr
Fayetteville, NC 28306-8453 - Phone
- (973) 735-3251
- NPI assigned
- Nov 29, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 51264 | NC | Primary |
Addresses
Primary practice location
500 Grouper Dr
Fayetteville, NC 28306-8453
Mailing address
500 Grouper Dr
Fayetteville, NC 28306-8453
Phone (973) 735-3251
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51264 | NC | MD | Oral and Maxillofacial Pathology Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543449600000",
"number": "1114497393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 GROUPER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283068453",
"telephone_number": "973-735-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 GROUPER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283068453",
"telephone_number": "973-735-3251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "LESLIE",
"middle_name": "ANNETTE",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-29",
"last_updated": "2018-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NC",
"license": "51264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.