Individual provider Active NPI

Morgan Wyatt Simmons, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1174616080
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN065733/AP03678 Issued in LA
Practice address
3408 Medical Park Dr
Monroe, LA 71203-2354
Phone
(318) 323-2244
Fax
(318) 387-9595
NPI assigned
Oct 2, 2006
Last updated
Jun 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN065733/AP03678 LA Primary

Addresses

Primary practice location

3408 Medical Park Dr
Monroe, LA 71203-2354

Mailing address

3408 Medical Park Dr
Monroe, LA 71203-2354
Phone (318) 323-2244

Other identifiers 1

IdentifierTypeStateIssuer
1104248MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000100 LA Practitioner - Nurse Practitioner 6901846062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1245 Glenwood Dr
West Monroe, LA 71291-5539
Phone (318) 361-3878

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN065733/AP03678LAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MSW Concepts Women's Health CurrentSince Nov 2, 2016 Accepting new patients
Women's Health Care of Monroe Current Accepting new patients
Janice R. Pharr, MD, LLC Past Accepting new patients

Locations

3408 Medical Park Dr
Monroe, LA 71203
Phone (318) 237-3930

3408 Medical Park Dr
Ste B
Monroe, LA 71203

1245 Glenwood Dr
West Monroe, LA 71291
Phone (318) 361-3878

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1174616080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 MEDICAL PARK DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032354",
            "telephone_number": "318-323-2244",
            "fax_number": "318-387-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 MEDICAL PARK DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032354",
            "telephone_number": "318-323-2244",
            "fax_number": "318-387-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MORGAN",
        "middle_name": "WYATT",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "RN065733/AP03678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104248",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.