Individual provider Active NPI

Richard Edward Simmons, M.D.

  • Nephrology Physician
  • Ft Collins, CO
National Provider Identifier
1366430100
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
29420 Issued in CO
Practice address
1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311
Phone
(970) 493-7733
Fax
(970) 493-8745
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 29420 CO Primary

Addresses

Primary practice location

1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311

Mailing address

1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311
Phone (970) 493-7733

Other identifiers 1

IdentifierTypeStateIssuer
01294206MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000512 CO Practitioner - Nephrology 7719922517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29420COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Clinic PC Nephrology CurrentSince Jul 7, 1997 Accepting new patients
US Health Dept of Health & Human Services Past Accepting new patients
US Health Dept of Health & Human Services Past Accepting new patients

Locations

1600 Specht Point Rd
Ste 127
Fort Collins, CO 80525

3351 Eastbrook Dr
Ste 100
Fort Collins, CO 80525

Organizations & group practices 3

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1366430100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "SUITE 127",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "SUITE 127",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "29420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01294206",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Collins, CO

Sources for this page

Verify at the official NPI Registry.