Individual provider Active NPI

Joquette S Simmons, CMA

  • Home Health Agency
  • Summerville, SC
National Provider Identifier
1417513540
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2398185 Issued in SC
Practice address
166 Danzid Dr
Summerville, SC 29483-9283
Phone
(843) 695-7452
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2398185 SC Primary

Addresses

Primary practice location

166 Danzid Dr
Summerville, SC 29483-9283

Mailing address

166 Danzid Dr
Summerville, SC 29483-9283
Phone (843) 695-7452

Other names 1

  • Joquette S Ricks Former name

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
Credentials
Certified Medical Assistant

State licenses

LicenseStateTypeSpecialty
2398185SCMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1417513540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 DANZID DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839283",
            "telephone_number": "843-695-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 DANZID DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839283",
            "telephone_number": "843-695-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOQUETTE",
        "middle_name": "S",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "2398185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOQUETTE",
            "last_name": "RICKS",
            "middle_name": "S",
            "credential": "CMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.