Richard Douglas Simonson

Primary specialty

PharmacistTaxonomy code 183500000X

License

051033841 Issued in IL

Practice address

2701 Columbus St
Ottawa, IL 61350-1005

Phone

(815) 434-1395

Fax

(815) 434-1396

NPI assigned

Nov 21, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Ottawa, IL
  • NPI 1538232152
  NPD (past)
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1164068342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 COLUMBUS ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501005",
            "telephone_number": "815-434-1395",
            "fax_number": "815-434-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 COLUMBUS ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501005",
            "telephone_number": "815-434-1395",
            "fax_number": "815-434-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "RICHARD",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051033841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "richard.simonson@kroger.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2701 Columbus St",
            "city": "Ottawa",
            "state": "IL",
            "country_code": "US",
            "postal_code": "613501005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serenityonwheels, Inc.
• Calym Setser
• Tushar S Shah, DDS
• Clayton Shick, DNP, CRNA
• Kayla A Simons, NP
• Lauren M Sladek, APN
• Sleep Better Inc
• Small Hands Building Blocks, Inc.
• Smalltown Dental Ottawa PLLC
• Craig D Smith, OTR

• Pharmacist in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.