Carl Michael Simone, OD

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

121 N Madison St
Rockford, IL 61107-3949

Phone

(815) 963-3454

Fax

(815) 963-4384

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northern Illinois Optical Co., Inc.

  • Optician
  • Rockford, IL
  • NPI 1639252273

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407925100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N MADISON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073949",
            "telephone_number": "815-963-3454",
            "fax_number": "815-963-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N MADISON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073949",
            "telephone_number": "815-963-3454",
            "fax_number": "815-963-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONE",
        "first_name": "CARL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08123272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Christopher Silvi
• Christine Judith Simaytis, M.D.
• Jessica Simmons, NP
• Diane Michelle Simon, MS RD LDN
• Maju Simon, RPH
• Jan Simone, APN
• Erin Anne Simonovich, M.A.
• Simply Wellness Chiropractic, LLC
• Leah Simpson, PA
• Amy Marie Sims, M.A. CCC-SLP

• Optometrist in Rockford, IL
• Providers in Rockford, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.