Individual provider Active NPI

Lana Kelly Simmons, FNP-BC

  • Nurse Practitioner
  • Statesville, NC
National Provider Identifier
1134317241
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5003739 Issued in NC
Practice address
2347 Simonton Rd
Statesville, NC 28625-8246
Phone
(704) 873-4719
Fax
(704) 872-1810
NPI assigned
Oct 15, 2007
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5003739 NC Primary

Addresses

Primary practice location

2347 Simonton Rd
Statesville, NC 28625-8246

Mailing address

2347 Simonton Rd
Statesville, NC 28625-8246
Phone (704) 873-4719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000578 NC Practitioner - Nurse Practitioner 9436231271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice of Iredell County IncGroup PAC ID 2961427018, 12 clinicians

Practice addresses (Care Compare)

2347 Simonton Rd
Statesville, NC 28625-8246
Phone (704) 873-4719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5003739NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Iredell County, Inc CurrentSince Feb 17, 2025 Accepting new patients
Novant Health Medical Group, LLC PastSince Jul 1, 2019 Accepting new patients

Locations

2347 Simonton Rd
Statesville, NC 28625
Phone (704) 873-4719

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1134317241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 SIMONTON RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258246",
            "telephone_number": "704-873-4719",
            "fax_number": "704-872-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 SIMONTON RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258246",
            "telephone_number": "704-873-4719",
            "fax_number": "704-872-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "LANA",
        "middle_name": "KELLY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5003739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.