Individual provider Active NPI

Marie-Alexis Simieritsch, CRNP

  • Nurse Practitioner
  • Double Springs, AL
National Provider Identifier
1194717827
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1075181 Issued in AL
Practice address
15341 Highway 278
Double Springs, AL 35553-2407
Phone
(205) 489-3322
Fax
(205) 489-3325
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1075181 AL Primary

Addresses

Primary practice location

15341 Highway 278
Double Springs, AL 35553-2407

Mailing address

15341 Highway 278
Double Springs, AL 35553-2407
Phone (205) 489-3322

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
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1075181ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality of Life Health Services, Inc Current Accepting new patients
Quality of Life Health Services Inc Current Accepting new patients
Franklin Primary Health Center Inc. Current Accepting new patients

Locations

1411 Piedmont Cutoff
Gadsden, AL 35903
Phone (205) 492-0131

502 N 27th St
Gadsden, AL 35904
Phone (256) 546-0073

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

Organizations & group practices 3

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1194717827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15341 HIGHWAY 278",
            "city": "DOUBLE SPRINGS",
            "state": "AL",
            "postal_code": "355532407",
            "telephone_number": "205-489-3322",
            "fax_number": "205-489-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15341 HIGHWAY 278",
            "city": "DOUBLE SPRINGS",
            "state": "AL",
            "postal_code": "355532407",
            "telephone_number": "205-489-3322",
            "fax_number": "205-489-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMIERITSCH",
        "first_name": "MARIE-ALEXIS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1075181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Double Springs, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.