Individual provider Active NPI

Simone Yates

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1366386286
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
49749 Issued in TN
Practice address
11701 Detroit Ave
Cleveland, OH 44107-3041
Phone
(216) 227-0819
NPI assigned
Apr 20, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03446508 OH
Pharmacist 183500000X 49749 TN Primary

Addresses

Primary practice location

11701 Detroit Ave
Cleveland, OH 44107-3041

Mailing address

2111 Lee PL
Memphis, TN 38104-2805
Phone (901) 833-3398

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

LicenseStateTypeSpecialty
03446508OHMDPharmacist
49749TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1366386286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 LEE PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042805",
            "telephone_number": "901-833-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441073041",
            "telephone_number": "216-227-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "SIMONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03446508",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "49749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.