Individual provider Active NPI

Sandra Simmons, MD

  • Pediatric Adolescent Medicine Physician
  • Missoula, MT
National Provider Identifier
1184634305
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MT10051 Issued in MT
Practice address
2835 Fort Missoula Rd
Missoula Valley Pediatrics Ste 205
Missoula, MT 59804
Phone
(406) 542-0391
NPI assigned
Aug 9, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT10051 MT
Pediatric Adolescent Medicine Physician 2080A0000X MT10051 MT Primary

Addresses

Primary practice location

2835 Fort Missoula Rd
Missoula Valley Pediatrics Ste 205
Missoula, MT 59804

Mailing address

PO Box 16900
Missoula, MT 59808
Phone (406) 327-4620

Other identifiers 1

IdentifierTypeStateIssuer
0047668MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150326001385 MT Practitioner - Pediatric Medicine 2365769502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT10051MTMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP Billings - Missoula LLC Current Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Jan 16, 2015 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Jan 16, 2015 Accepting new patients

Locations

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2835 Fort Missoula Rd
Ste 205
Missoula, MT 59804
Phone (406) 542-0391

Interoperability endpoints

  • Direct secure messaging: ssimmons@direct.communitymed.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184634305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16900",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59808",
            "telephone_number": "406-327-4620",
            "fax_number": "406-549-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD",
            "address_2": "MISSOULA VALLEY PEDIATRICS STE 205",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59804",
            "telephone_number": "406-542-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "MT10051",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MT",
            "license": "MT10051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0047668",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.