Shavone Simmonds, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 9108356 Issued in FL

Practice address

1887 Kingsley Ave
Suite 1900
Orange Park, FL 32073-4416

Phone

(904) 272-9981

NPI assigned

Sep 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• FM Medical Inc

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1588091029
  NPD (past)

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1134598857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 TOUCHTON RD",
            "address_2": "APT. #638",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468296",
            "telephone_number": "571-521-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE",
            "address_2": "SUITE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734416",
            "telephone_number": "904-272-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONDS",
        "first_name": "SHAVONE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9108356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaira Enid Silva, LMT
• Silver Linings Community Care, LLC.
• Richard Silverman
• Virginia Silverman, HAS
• Elizabeth Sim, M.D.
• Amy Simmons, PTA
• Dwelvin L Simmons, MD
• Christian Michael Simon, DO
• Janie M Simpson, LCSW
• Yvette Lavallee Sims, ARNP

• Surgical Physician Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.