Active NPI
Takelia Simmons
- Adult Psychiatric/Mental Health Registered Nurse
- La Plata, MD
National Provider Identifier
1396508792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- R243046
- Practice address
- 1014 Washington Ave
La Plata, MD 20646-4228 - Phone
- (240) 462-3562
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | R243046 | MD | Primary |
Addresses
Primary practice location
1014 Washington Ave
La Plata, MD 20646-4228
Mailing address
1037 Rye Dr
La Plata, MD 20646-3241
Phone (240) 462-3562
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
| License | State | Type | Specialty |
|---|---|---|---|
| R243046 | MD | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1396508792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1037 RYE DR",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206463241",
"telephone_number": "240-462-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 WASHINGTON AVE",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206464228",
"telephone_number": "240-462-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "TAKELIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "MD",
"license": "R243046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Plata, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.