Individual provider Active NPI

Heather Jo Simon, PA

  • Physician Assistant
  • Greenville, MI
National Provider Identifier
1235445164
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005842 Issued in MI
Practice address
1014 E Washington St
Greenville, MI 48838-2463
Phone
(616) 754-7145
NPI assigned
Aug 30, 2010
Last updated
Aug 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005842 MI Primary

Addresses

Primary practice location

1014 E Washington St
Greenville, MI 48838-2463

Mailing address

1014 E Washington St
Greenville, MI 48838-2463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026000157 MI Practitioner - Physician Assistant 6608069307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sparrow Carson HospitalGroup PAC ID 7113836701, 63 clinicians

Practice addresses (Care Compare)

1014 E Washington St
Greenville, MI 48838-2463
Phone (616) 754-7145

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Aug 26, 2010 Accepting new patients
Sparrow Carson Hospital CurrentSince Aug 26, 2010 Accepting new patients
Sparrow Carson Hospital Past Accepting new patients
Sparrow Carson Hospital Past Accepting new patients
Sparrow Carson Hospital Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

1014 E Washington St
Ste B
Greenville, MI 48838

545 N State St
Stanton, MI 48888
Phone (989) 584-3131

Interoperability endpoints

  • Direct secure messaging: hsimon53350@sparrowdirecthie.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1235445164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 E WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 E WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382463",
            "telephone_number": "616-754-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "HEATHER",
        "middle_name": "JO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

Verify at the official NPI Registry.