John Walton Simmons Sr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5819 Issued in SC

Practice address

4245 Clifton Glendale Rd
Spartanburg, SC 29307-3409

Phone

(864) 266-7164

NPI assigned

Jan 19, 2011

Sex

Male

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1154626430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 E MAIN ST",
            "address_2": "SUITE 14 BOX 6",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072309",
            "telephone_number": "864-266-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 CLIFTON GLENDALE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293073409",
            "telephone_number": "864-266-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOHN",
        "middle_name": "WALTON",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "5819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Shuster, MD
• Arlene Si
• Farhan Siddiqui, M.D.
• Michael Joseph Siebert, OD
• Scott Michael Silver, MD
• Mary Elizabeth Simmons, LPC
• Taylor Marie Simmons, D.O.
• Ifekan-Shango Simon
• Andrew Thomas Simpson, D.O.
• Heber Grant Sims, O.D.

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.