Bertha Y Carter-Simmons, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

052258 Issued in MO

Practice address

111 S Meramec Ave
Clayton, MO 63105-1711

Phone

(314) 615-8153

Fax

(314) 615-8303

NPI assigned

Aug 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• County of St Louis Division of Fiscal Management

  dba John C. Murphy Health Center

  • Federally Qualified Health Center (FQHC)
  • Berkeley, MO
  • NPI 1184519506
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184739609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S MERAMEC AVE",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051711",
            "telephone_number": "314-615-8153",
            "fax_number": "314-615-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S MERAMEC AVE",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051711",
            "telephone_number": "314-615-8153",
            "fax_number": "314-615-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER-SIMMONS",
        "first_name": "BERTHA",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "052258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423989417",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00213367",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Nichole Cantrell, LPC
• Savannah Jual Carlson, PT, DPT
• Carosello Psychotherapy, LLC
• Olivia Harman Carosello, MSW, LCSW
• Lisa Carroll
• Hilary Woollen Cedergreen, PLPC
• Center for Integrated Health, LLC
• Christina Maria Chavosy, M.S., CF-SLP
• Steven D. Chod, D.D.S.
• Kailye Kelly Chu, PHARM.D.

• Nurse Practitioner in Clayton, MO
• Providers in Clayton, MO by specialty
• Nurse Practitioner in Missouri

• 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.