Individual provider Active NPI

Roseann Judith Simone

  • Assisted Living Facility
  • Cocoa Beach, FL
National Provider Identifier
1184967184
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10561 Issued in FL
Practice address
280 Bahama Dr
Angel Guardian
Cocoa Beach, FL 32952
Phone
(321) 223-8371
NPI assigned
Mar 28, 2013
Last updated
Mar 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10561 FL Primary

Addresses

Primary practice location

280 Bahama Dr
Angel Guardian
Cocoa Beach, FL 32952

Mailing address

280 Bahama Dr
Merritt Island, FL 32952-3605

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL10561FLMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Guardian Assisted Living Assisted Living Facility Past Accepting new patients

Organizations & group practices 1

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1184967184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BAHAMA DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BAHAMA DR",
            "address_2": "ANGEL GUARDIAN",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-223-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONE",
        "first_name": "ROSEANN",
        "middle_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.