Individual provider Active NPI

Corey Dominique Simmons

  • Non-emergency Medical Transport (VAN)
  • Chesapeake, VA
National Provider Identifier
1427653088
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
2005 Old Greenbrier Rd Ste 102
Chesapeake, VA 23320-2649
Phone
(757) 524-2238
NPI assigned
Dec 2, 2020
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NU Primary

Addresses

Primary practice location

2005 Old Greenbrier Rd Ste 102
Chesapeake, VA 23320-2649

Mailing address

2325 Grandy Ave
Norfolk, VA 23509-2211
Phone (757) 470-6379

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL http://www.medtunnel.com/

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

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1427653088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 GRANDY AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235092211",
            "telephone_number": "757-470-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 OLD GREENBRIER RD STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202649",
            "telephone_number": "757-524-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "COREY",
        "middle_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.medtunnel.com/",
            "affiliation": "N",
            "endpointDescription": "HIPAA Compliant messaging",
            "address_1": "2005 Old Greenbrier Rd Ste 102",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233202649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.