Individual provider Active NPI

Damien Simmons

  • Pharmacist
  • Atlantis, FL
National Provider Identifier
1134635006
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40989 Issued in FL
Practice address
100 John F Kennedy Dr
Atlantis, FL 33462-1120
Phone
(561) 232-2893
Fax
(561) 360-2226
NPI assigned
Dec 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40989 FL Primary

Addresses

Primary practice location

100 John F Kennedy Dr
Atlantis, FL 33462-1120

Mailing address

100 John F Kennedy Dr
Atlantis, FL 33462-1120
Phone (561) 232-2893

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
PS40989FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantis Pharmacy RX LLC Current Accepting new patients
Atlantis Pharmacy LTC LLC Current Accepting new patients

Locations

100 John F Kennedy Dr
Lake Worth, FL 33462
Phone (561) 232-2893

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1134635006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JOHN F KENNEDY DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621120",
            "telephone_number": "561-232-2893",
            "fax_number": "561-360-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOHN F KENNEDY DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621120",
            "telephone_number": "561-232-2893",
            "fax_number": "561-360-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DAMIEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.