Individual provider Active NPI

Joyce L. Simpson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
National Provider Identifier
1205831559
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01039663 Issued in IN
Practice address
5620 Southwyck Blvd
Toledo, OH 43614-1501
Phone
(800) 288-8325
Fax
(419) 866-5453
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01039663 IN Primary

Addresses

Primary practice location

5620 Southwyck Blvd
Toledo, OH 43614-1501

Mailing address

530 North Lafayette Blvd.
South Bend, IN 46614
Phone (574) 234-4176

Other identifiers 3

IdentifierTypeStateIssuer
200094740AMedicaidIN
000000091641OtherINANTHEM
3496455MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070730000296 IN Practitioner - Pathology 2567563935 Reassigns benefits to 2 organizations
I20190306000808 MI Practitioner - Pathology 2567563935 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01039663INMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2007 Accepting new patients
Legacy Path LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 17, 2024 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2007 Accepting new patients

Locations

530 N Lafayette Blvd
South Bend, IN 46601
Phone (574) 204-5206

3355 Douglas Rd
South Bend, IN 46635
Phone (574) 234-4176

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

5700 Southwyck Blvd
Toledo, OH 43614

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1205831559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NORTH LAFAYETTE BLVD.",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46614",
            "telephone_number": "574-234-4176",
            "fax_number": "574-234-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141501",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "JOYCE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01039663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200094740A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000091641",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3496455",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.