Active NPI
Donna Jean Simmons, NBC-HWC
- Health & Wellness Coach
- Berkley, MI
National Provider Identifier
1295591923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- A-3255023
- Practice address
- 4123 Cornwall St
Berkley, MI 48072-1660 - Phone
- (124) 876-3203
- NPI assigned
- Feb 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | A-3255023 | MI | Primary |
Addresses
Primary practice location
4123 Cornwall St
Berkley, MI 48072-1660
Mailing address
4123 Cornwall St
Berkley, MI 48072-1660
Phone (124) 876-3203
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
| License | State | Type | Specialty |
|---|---|---|---|
| A-3255023 | MI | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1295591923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4123 CORNWALL ST",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480721660",
"telephone_number": "124-876-3203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4123 CORNWALL ST",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480721660",
"telephone_number": "124-876-3203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "DONNA",
"middle_name": "JEAN",
"credential": "NBC-HWC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-21",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "MI",
"license": "A-3255023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkley, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.