Individual provider Active NPI

Janice D Simmons, ARNP

  • Acute Care Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1114923018
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
L101908 Issued in IA
Practice address
1351 W Central Park Ave
Ste 420
Davenport, IA 52804-1853
Phone
(563) 421-1422
Fax
(563) 421-1430
NPI assigned
Jun 24, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X L101908 IA Primary
Acute Care Nurse Practitioner 363LA2100X IL

Addresses

Primary practice location

1351 W Central Park Ave
Ste 420
Davenport, IA 52804-1853

Mailing address

1351 W Central Park Ave
Ste 420
Davenport, IA 52804-1853
Phone (563) 421-1422

Other identifiers 3

IdentifierTypeStateIssuer
IA0182OtherIAJOHN DEERE
09751OtherIAWELLMARK OF IA
1462978MedicaidIA

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Acute Care Past Accepting new patients
Genesis Health System Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114923018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 W CENTRAL PARK AVE",
            "address_2": "STE 420",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041853",
            "telephone_number": "563-421-1422",
            "fax_number": "563-421-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 W CENTRAL PARK AVE",
            "address_2": "STE 420",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041853",
            "telephone_number": "563-421-1422",
            "fax_number": "563-421-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JANICE",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "L101908",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IA0182",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK OF IA",
            "identifier": "09751",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1462978",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.