NPIMap

Organization Active NPI

Sharonelle Simmons, M.D

  • Family Medicine Physician
  • Tempe, AZ
National Provider Identifier
1295057354
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13628 Issued in AZ
Legal business name
SHARONELLE SIMMONS, M.D
Practice address
6200 S McClintock Dr Ste 104
Tempe, AZ 85283-3268
Phone
(480) 388-3666
Fax
(480) 388-3667
NPI assigned
Feb 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Authorized official

Name
Dr. Sharonelle Simmons, M.D.NPI 1649233610
Title
Member/Medical Director
Phone
(480) 949-1182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 13628 AZ Primary
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

6200 S McClintock Dr Ste 104
Tempe, AZ 85283-3268

Mailing address

6200 S McClintock Dr Ste 104
Tempe, AZ 85283-3268
Phone (480) 388-3666

Other identifiers 3

IdentifierTypeStateIssuer
2569417OtherAZAETNA
1Z7430OtherHEALTHNET
AZ0071880OtherAZBC/BS OF AZ.

National Provider Directory

National Provider Directory

Locations

6200 S McClintock Dr
#10
Tempe, AZ 85283
Phone (480) 388-3666

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1295057354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 S MCCLINTOCK DR STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833268",
            "telephone_number": "480-388-3666",
            "fax_number": "480-388-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 S MCCLINTOCK DR STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833268",
            "telephone_number": "480-388-3666",
            "fax_number": "480-388-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARONELLE SIMMONS, M.D",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "SHARONELLE",
        "authorized_official_title_or_position": "MEMBER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-949-1182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "13628",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2569417",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z7430",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AZ.",
            "identifier": "AZ0071880",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.