Samuel Livaudois Simpson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20478 Issued in MS

Practice address

1513 Union Ave
Suite 2300
Moberly, MO 65270-9407

Phone

(660) 263-8309

Fax

(660) 263-1948

NPI assigned

Jul 5, 2005

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssimpson85217@ummc.direct-ci.com

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.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Moberly Hospital Company LLC

  dba Chariton Valley Family Medicine

  • Rural Health Clinic/Center
  • Salisbury, MO
  • NPI 1851713580
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1255338349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "JMM SUITE 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392163921",
            "telephone_number": "601-815-9528",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 UNION AVE",
            "address_2": "SUITE 2300",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8309",
            "fax_number": "660-263-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "SAMUEL",
        "middle_name": "LIVAUDOIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "20478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04329316",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207268004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alicia C Shaw, FNP
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• Skilled Nursing Services LLC (Loma Linda)
• Smile Dental Associates, LLC
• Alicia Elizabeth Smith
• Caitlyn Justine Smith, COTA
• Claire Riane Smith, MD

• Pediatrics Physician in Moberly, MO
• Providers in Moberly, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.