Individual provider Active NPI

Robert Lee Simmons, D.C.

  • Orthopedic Chiropractor
  • San Diego, CA
National Provider Identifier
1184636102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
28430 Issued in CA
Practice address
9484 Black Mountain Rd
Suite I
San Diego, CA 92126-4520
Phone
(858) 566-2446
Fax
(858) 566-2448
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 28430 CA Primary

Addresses

Primary practice location

9484 Black Mountain Rd
Suite I
San Diego, CA 92126-4520

Mailing address

9484 Black Mountain Rd
Suite I
San Diego, CA 92126-4520
Phone (858) 566-2446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28430CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Simmons Chiropractic, Inc. Orthopedic PastSince Jun 1, 2006 Accepting new patients
Broadway Chiropractic and Therapy Center Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184636102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9484 BLACK MOUNTAIN RD",
            "address_2": "SUITE I",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264520",
            "telephone_number": "858-566-2446",
            "fax_number": "858-566-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9484 BLACK MOUNTAIN RD",
            "address_2": "SUITE I",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264520",
            "telephone_number": "858-566-2446",
            "fax_number": "858-566-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "28430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.