Jeannine Marie Simmons, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A1953 Issued in MN

Practice address

1810 Minnesota Blvd
Saint Cloud, MN 56304-2436

Phone

(320) 252-0010

NPI assigned

Jul 19, 2017

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1194248468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 KENABEC ST",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099412",
            "telephone_number": "763-291-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MINNESOTA BLVD",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563042436",
            "telephone_number": "320-252-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JEANNINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A1953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSISTANT",
            "identifier": "A1953",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Royann M Sienko, RN
• Michael Siergiej, CRNA
• Danielle Marie Sievek
• Elizabeth Alison Sikes, MD
• Silvia Spinal Center PC
• Michelle L Simmons, CRNA
• Jessica Donna Simon
• Monseline Simon
• Jennifer Beth Simondet
• Tereasa M Simonson, M.D.

• Physical Therapy Assistant in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.