Jerry Gordon Simon

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

3314 Henderson Blvd Ste 100E
Tampa, FL 33609-2999

Phone

(813) 391-5909

Fax

(813) 864-6741

NPI assigned

Jan 25, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Pacifica Services, Inc.

  • Home Health Agency
  • Tampa, FL
  • NPI 1487325775
  NPD Authorized official

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1164012993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 HENDERSON BLVD STE 100E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092999",
            "telephone_number": "813-391-5909",
            "fax_number": "813-864-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 HENDERSON BLVD STE 100E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092999",
            "telephone_number": "813-391-5909",
            "fax_number": "813-864-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JERRY",
        "middle_name": "GORDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104946200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NPI",
            "affiliation": "N",
            "endpointDescription": "NPI",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NPI",
            "address_1": "3314 Henderson Blvd Ste 100E",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336092999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher J Simms, PT
• Diona Silas Simms, FNP-BC
• Lisa Marie Simms
• Michael Simoes, MD
• James William Simon, APRN
• Keith Simon, DMD
• Reema Elalam Simon, DO
• Ross Simon, MD
• Shannon Simon, LPN/NRP
• Carissa Simone, M.D.

• Home Health Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.