Individual provider Active NPI

Kristen Nicole Simon, PHARM D

  • Pharmacist
  • Amityville, NY
National Provider Identifier
1144473380
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
052956-1 Issued in NY
Practice address
351 Merrick Rd
Amityville, NY 11701-3420
Phone
(631) 691-0304
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 052956-1 NY Primary

Addresses

Primary practice location

351 Merrick Rd
Amityville, NY 11701-3420

Mailing address

55 Motor Ave
Farmingdale, NY 11735-4040
Phone (631) 756-5134

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
052956-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stop and Shop Supermarket Co LLC Past Accepting new patients
The Stop & Shop Supermarket Company LLC Past Accepting new patients

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1144473380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MOTOR AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354040",
            "telephone_number": "631-756-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 MERRICK RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013420",
            "telephone_number": "631-691-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "052956-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; 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.