Nathan Allen Simmons, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-48788 Issued in OR

Practice address

1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102

Phone

(866) 523-4268

NPI assigned

Jul 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Footprints Behavior Interventions

  • Community/Behavioral Health Agency
  • Fountain Valley, CA
  • NPI 1770004830
  NPD (past)
• Footprints Behavioral Interventions, Inc.

  • Early Intervention Provider Agency
  • Santa Ana, CA
  • NPI 1780978858
  NPD (past)

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1124540505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 22763",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911852763",
            "telephone_number": "866-523-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Cherry Ave NE",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973034855",
            "country_code": "US",
            "telephone_number": "503-551-4746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11037 Warner Ave, #339",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "92708",
            "country_code": "US",
            "telephone_number": "800-273-4292",
            "fax_number": "949-253-4627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "NATHAN",
        "middle_name": "ALLEN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "1-21-48788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Jean Simmons, FNP
• Derek Simmons, NP
• Kaitlyn Simmons, MD, MPH
• Lauren Tsaile Simmons
• Michelle Simmons
• Patricia Diane Simmons, NONE
• Stacy Simmons, MA
• Stephanie Kaye Simmons
• Steven M Simmons, DMD
• Troy Wayne Simmons, D.P.M.

• Behavior Analyst in Portland, OR
• Providers in Portland, OR by specialty
• Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.