Simy Suresh Antony, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95007018 Issued in CA

Practice address

435 Doyle Park Dr
Santa Rosa, CA 95405-4515

Phone

(707) 527-9510

Fax

(707) 527-1306

NPI assigned

Oct 29, 2017

Last updated

Jan 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1316459407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 OAKSTONE WAY",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031458",
            "telephone_number": "707-704-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "707-527-1306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Hawthorne Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093108",
            "country_code": "US",
            "telephone_number": "510-869-8865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURESH ANTONY",
        "first_name": "SIMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-29",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Sumpango
• Chandi Sun, PHARMD
• Support Our Students
• Katrina Lynne Suprise, LCSW
• Marie Eleese Surber
• Lana M Surgenor, D.C.
• Surgical Neuromonitoring Service Inc
• Vikki Suzanne Sutherland, D.C.
• Laura Sutliff, RN
• Sutter Bay Hospitals

• Family Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.