Agnes a Enrico-Simon, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AGNES A ENRICO-SIMON, PLLC

Practice address

2415 Jackson Ave
PT Pleasant, WV 25550-2042

Phone

(304) 675-6090

Fax

(304) 675-5893

NPI assigned

Jun 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Agnes A Enrico-Simon, MDNPI 1003910670

Title

Physician

Phone

(304) 675-6817

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Agnes A Enrico-Simon, MD

  • Family Medicine Physician
  • PT Pleasant, WV
  • NPI 1003910670
  Authorized official Same address or phone

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386846707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 JACKSON AVE",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "255502042",
            "telephone_number": "304-675-6090",
            "fax_number": "304-675-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 JACKSON AVE",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "255502042",
            "telephone_number": "304-675-6090",
            "fax_number": "304-675-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES A ENRICO-SIMON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENRICO-SIMON",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "304-675-6817",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002914000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold Edward Ayers Jr., MD
• Breton L Morgan, M.D., Inc.
• Misty D Burgos
• Helen Jane Carry, RN
• Jeremy Cochran, LGSW

• Family Medicine Physician in PT Pleasant, WV
• Providers in PT Pleasant, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.