Individual provider Active NPI

David Brian Simmons, BA, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Wichita, KS
National Provider Identifier
1205194099
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
558 Issued in KS
Practice address
4031 E Harry St Ste 43
Wichita, KS 67218-3724
Phone
(316) 771-7413
NPI assigned
Apr 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 558 KS Primary

Addresses

Primary practice location

4031 E Harry St Ste 43
Wichita, KS 67218-3724

Mailing address

2035 N Beaumont St
Wichita, KS 67208-1727
Phone (316) 409-5242

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
558KSMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1205194099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 N BEAUMONT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672081727",
            "telephone_number": "316-409-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 E HARRY ST STE 43",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183724",
            "telephone_number": "316-771-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "BA, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.