Kellie Simmons, CRNP

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

SP008870 Issued in PA

Practice address

3401 N Broad St
Gastroenterology - 3Rd FL Ambulatory Care Center
Philadelphia, PA 19140-5103

Phone

(215) 707-9900

Fax

(215) 707-3831

NPI assigned

Jun 1, 2007

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

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1386846467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "address_2": "3/208N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-4739",
            "fax_number": "215-707-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "GASTROENTEROLOGY - 3RD FL AMBULATORY CARE CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-9900",
            "fax_number": "215-707-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KELLIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "PA",
            "license": "SP008870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Simmons III
• Hanesha Simmons, RN
• Jennifer C. Simmons, M.D.
• John Preston Simmons, MD
• Joseph Edwin Simmons, CRNA
• Malanna Simmons
• Martha Ayre Simmons, MD
• Natalie Sherese Simmons
• Nia Simmons
• Rebecca A Simmons, MD

• Adult Health Clinical Nurse Specialist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Health Clinical Nurse Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.