Maryellen Simko, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

002739 Issued in CT

Practice address

95 Hockanum Blvd
Unit 5013
Vernon, CT 06066-4099

Phone

(860) 538-5049

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1154428282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HOCKANUM BLVD",
            "address_2": "UNIT 5013",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664099",
            "telephone_number": "860-538-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HOCKANUM BLVD",
            "address_2": "UNIT 5013",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664099",
            "telephone_number": "860-538-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMKO",
        "first_name": "MARYELLEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "002739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004265006",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Girish L Sharma, MD
• Michael R Sharon, MD
• Leeanne E Shaw-Quinn, APRN
• Shaws Supermarkets Inc
• Michael Shlafstein, DDS
• Carsia D Simms
• Daniel Sindler
• Erin Smith-Green, LMFT
• Casey Lynn Smith-Speirs, LCSW
• Hollie Suzanne Smith, APRN

• Adult Health Nurse Practitioner in Vernon, CT
• Providers in Vernon, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.