L. Keith Simmons, DO

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

2902 Issued in OK

Practice address

9709 E 79TH St S
Tulsa, OK 74133-4566

Phone

(918) 994-4000

Fax

(918) 994-4090

NPI assigned

Jul 28, 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 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: larry.simmons@direct.stjohnhealthsystem.com

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.

• Mpower Clinical TX

  • Clinical Neurophysiology Physician
  • San Antonio, TX
  • NPI 1134737216

  OK

  Medicare reassignment NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1447264205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST S",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4000",
            "fax_number": "918-994-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 E 79TH ST S",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334566",
            "telephone_number": "918-994-4000",
            "fax_number": "918-994-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "L.",
        "middle_name": "KEITH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "2902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124910A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00340518",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coeta Simmons
• Denise Simmons, PT
• Diane Simmons
• Jensen Brese Simmons
• Katrina Nicole Simmons
• Lai Simmons
• Rachel Simmons, LCSW
• Sandra Ellen Simmons
• Valerie Simmons
• Alexandra Simms

• Neurological Surgery Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Neurological Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.