Individual provider Active NPI

Cindy Marie Simmons, PA-C

  • Physician Assistant
  • Trenton, GA
National Provider Identifier
1184783771
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2943 Issued in GA
Practice address
111 North Pine Street
Trenton, GA 30752
Phone
(706) 657-3360
Fax
(706) 657-4400
NPI assigned
Dec 8, 2006
Last updated
Dec 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2943 GA Primary
Physician Assistant 363A00000X 1260 TN

Addresses

Primary practice location

111 North Pine Street
Trenton, GA 30752

Mailing address

12978 N. Main Street
Trenton, GA 30752
Phone (706) 657-4183

Other identifiers 1

IdentifierTypeStateIssuer
181516355AMedicaidGA

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2943GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation, Inc Current Accepting new patients
Advanced Center for Sleep Disorders, Inc. Past Accepting new patients
HMC Physician Billing LLC Past Accepting new patients
Advanced Center for Sleep Disorders, Inc Past Accepting new patients
Hutcheson Primary Care, LLC Past Accepting new patients

Locations

611 E Villanow St
La Fayette, GA 30728
Phone (706) 638-1606

4750 Battlefield Pkwy
Ringgold, GA 30736
Phone (706) 841-8050

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

Interoperability endpoints

  • Direct secure messaging: cindysimmons@tnmhpf.allscriptsdirect.net

Organizations & group practices 5

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1184783771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12978 N. MAIN STREET",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "30752",
            "telephone_number": "706-657-4183",
            "fax_number": "706-657-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTH PINE STREET",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "30752",
            "telephone_number": "706-657-3360",
            "fax_number": "706-657-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CINDY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "2943",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181516355A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.