Individual provider Active NPI

Tera D Simmons, PTA

  • Physical Therapy Assistant
  • Mountain View, AR
National Provider Identifier
1124249347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1665 Issued in AR
Practice address
416 Massey Ave
Mountain View, AR 72560-6132
Phone
(870) 269-2871
Fax
(870) 269-6169
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1665 AR Primary

Addresses

Primary practice location

416 Massey Ave
Mountain View, AR 72560-6132

Mailing address

PO Box 510
Mountain View, AR 72560-0510
Phone (870) 269-2871

Other identifiers 1

IdentifierTypeStateIssuer
1665OtherARSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
1665ARMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
White River Health System, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124249347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725600510",
            "telephone_number": "870-269-2871",
            "fax_number": "870-269-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 MASSEY AVE",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725606132",
            "telephone_number": "870-269-2871",
            "fax_number": "870-269-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TERA",
        "middle_name": "D",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "1665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1665",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.