Mark Douglas Simmons, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05002822A Issued in IN

Practice address

2560 N County Road 20 W
North Vernon, IN 47265-8202

Phone

(812) 801-1362

NPI assigned

Feb 7, 2011

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lammas,LLC

  • Physical Therapy Clinic/Center
  • North Vernon, IN
  • NPI 1033503750
  NPD (past) Authorized official

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1316243439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 N COUNTY ROAD 20 W",
            "address_2": "CEDAR KNOLL FARMS",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472658202",
            "telephone_number": "812-801-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N COUNTY ROAD 20 W",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472658202",
            "telephone_number": "812-801-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002822A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY PHYSICAL THERAPY",
            "identifier": "05002822A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southeast Indiana Mental Health Professionals, LLC

• Physical Therapist in North Vernon, IN
• Providers in North Vernon, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.