Individual provider Active NPI

Susan Louise Simmons, BS RN

  • Home Health Registered Nurse
  • Penn Yan, NY
National Provider Identifier
1457596512
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
312941 Issued in NY
Practice address
417 Liberty St Ste 2120
Penn Yan, NY 14527-1124
Phone
(315) 536-5160
NPI assigned
Dec 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 312941 NY Primary

Addresses

Primary practice location

417 Liberty St Ste 2120
Penn Yan, NY 14527-1124

Mailing address

1778 Lake to Lake Rd
Stanley, NY 14561-9562
Phone (585) 526-5915

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
Bachelor of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
312941NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1457596512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 LAKE TO LAKE RD",
            "city": "STANLEY",
            "state": "NY",
            "postal_code": "145619562",
            "telephone_number": "585-526-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST STE 2120",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271124",
            "telephone_number": "315-536-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SUSAN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "BS RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "312941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.