Individual provider Active NPI

Jonathan Brooks Simpson, DPM

  • Primary Podiatric Medicine Podiatrist
  • Charlotte, NC
National Provider Identifier
1265833479
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
638 Issued in NC
Practice address
5960 Fairview Rd Ste 300
Charlotte, NC 28210-0202
Phone
(888) 964-6681
Fax
(888) 662-0859
NPI assigned
Sep 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 638 NC
Primary Podiatric Medicine Podiatrist 213EP1101X 638 NC Primary

Addresses

Primary practice location

5960 Fairview Rd Ste 300
Charlotte, NC 28210-0202

Mailing address

355 W Martin Luther King Blvd Apt 2115
Charlotte, NC 28202-3081
Phone (980) 329-0006

Other practice location 1

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-4891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171228002763 NC Practitioner - Podiatry 0244598969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group NC, PCGroup PAC ID 5597172924, 9 clinicians

Practice addresses (Care Compare)

5960 Fairview Rd
Suite 300
Charlotte, NC 28210-0202
Phone (888) 964-6681

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1881
Removal or shaving of skin growth39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
638NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Podiatry Group NC, PC CurrentSince May 21, 2022 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

5960 Fairview Rd
Ste 300
Charlotte, NC 28210
Phone (732) 806-0804

Organizations & group practices 1

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": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1265833479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W MARTIN LUTHER KING BLVD APT 2115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282023081",
            "telephone_number": "980-329-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100202",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-4891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "JONATHAN",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-07",
        "last_updated": "2023-08-07",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "638",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.