Individual provider Active NPI

John Simmons Jr., LPN

  • Licensed Practical Nurse
  • North Charleston, SC
National Provider Identifier
1245412667
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PR38138 Issued in SC
Practice address
7702 Linsley Dr
North Charleston, SC 29418-3230
Phone
(843) 768-5539
Fax
(843) 225-6717
NPI assigned
Nov 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PR38138 SC Primary

Addresses

Primary practice location

7702 Linsley Dr
North Charleston, SC 29418-3230

Mailing address

7702 Linsley Dr
North Charleston, SC 29418-3230
Phone (843) 768-5539

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

State licenses

LicenseStateTypeSpecialty
PR38138SCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1245412667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 LINSLEY DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294183230",
            "telephone_number": "843-768-5539",
            "fax_number": "843-225-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 LINSLEY DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294183230",
            "telephone_number": "843-768-5539",
            "fax_number": "843-225-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "PR38138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.