Individual provider Active NPI

Cassey Diane Simons

  • Psychiatric/Mental Health Nurse Practitioner
  • El Dorado, AR
National Provider Identifier
1356038368
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
223526 Issued in AR
Practice address
143 Parkers RDG
El Dorado, AR 71730-3988
Phone
(870) 639-1117
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 223526 AR Primary

Addresses

Primary practice location

143 Parkers RDG
El Dorado, AR 71730-3988

Mailing address

143 Parkers RDG
El Dorado, AR 71730-3988
Phone (870) 639-1117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307000252 AR Practitioner - Nurse Practitioner 5799121224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Arkansas Regional Health CenterGroup PAC ID 0941199988, 14 clinicians

Practice addresses (Care Compare)

715 N College Ave
El Dorado, AR 71730-4403
Phone (870) 862-7921

Hospital & facility affiliations

  • Magnolia Regional Medical Center Hospital, Magnolia, AR, CCN 040067
  • Ouachita County Medical Center Hospital, Camden, AR, CCN 040050
  • South Arkansas Regional Hospital LLC Hospital, El Dorado, AR, CCN 040088
  • Magnolia Regional Medical Center Hospital, Magnolia, AR, CCN 041336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Regional Health Center CurrentSince Mar 27, 2024 Accepting new patients
South Arkansas Regional Health Center CurrentSince Mar 27, 2024 Accepting new patients

Locations

715 N College Ave
El Dorado, AR 71730
Phone (870) 862-7921

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1356038368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 PARKERS RDG",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717303988",
            "telephone_number": "870-639-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 PARKERS RDG",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717303988",
            "telephone_number": "870-639-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "CASSEY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "223526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.