Active NPI
Janice D Simmons, ARNP
- Acute Care Nurse Practitioner
- Davenport, IA
National Provider Identifier
1114923018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- L101908
- 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, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IA0182 | Other | IA | JOHN DEERE |
| 09751 | Other | IA | WELLMARK OF IA |
| 1462978 | Medicaid | IA |
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
| Organization | Specialty | Status | New 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.
-
dba Genesis Health Group
- Family Medicine Physician
- Bettendorf, IA
- NPI 1225018211
Acute Care
-
dba Genesis Medical Center - Physical Medicine and Rehabilitation
- Physical Medicine & Rehabilitation Physician
- Davenport, IA
- NPI 1760434658
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.