Individual provider Active NPI

Amanda Renee Simonds, D.C.

  • Chiropractor
  • Lees Summit, MO
National Provider Identifier
1144355165
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007004600 Issued in MO
Practice address
1008 SW Blue Pkwy
Lees Summit, MO 64063-2100
Phone
(816) 347-1515
Fax
(816) 347-0398
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2007004600 MO Primary

Addresses

Primary practice location

1008 SW Blue Pkwy
Lees Summit, MO 64063-2100

Mailing address

523 Regina CT
Raymore, MO 64083-8193
Phone (314) 974-5934

Other names 1

  • Amanda Renee Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000389 MO Practitioner - Chiropractic 0749317808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1008 SW Blue Pkwy
Lees Summit, MO 64063-2100
Phone (816) 347-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1144355165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 REGINA CT",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838193",
            "telephone_number": "314-974-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 SW BLUE PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632100",
            "telephone_number": "816-347-1515",
            "fax_number": "816-347-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONDS",
        "first_name": "AMANDA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007004600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CAMPBELL",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.