Active NPI
Anna Brown Simon, CRNP
- Family Nurse Practitioner
- Plymouth Meeting, PA
National Provider Identifier
1124170410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- TP005456B
- Practice address
- 2901 Jolly Rd
Plymouth Meeting, PA 19462-2324 - Phone
- (610) 272-8221
- NPI assigned
- Jan 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | TP005456B | PA | Primary |
Addresses
Primary practice location
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Mailing address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 341002403A | Medicaid | GA | |
| 0004379-00 | Medicaid | FL |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1124170410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 JOLLY RD",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194622324",
"telephone_number": "610-272-8221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 JOLLY RD",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194622324",
"telephone_number": "610-272-8221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "ANNA",
"middle_name": "BROWN",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "TP005456B",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "341002403A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004379-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.