Kaitlyn Soffray Simmons, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

212541 Issued in AR

Practice address

500 Kitchen St
Jonesboro, AR 72401-3135

Phone

(870) 972-4777

Fax

(870) 972-4722

NPI assigned

Oct 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St Bernards Hospital Inc.

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1396053096
  Medicare reassignment Care Compare group NPD
• Jonesboro Church Health Center

  • Primary Care Nurse Practitioner
  • Jonesboro, AR
  • NPI 1619809506
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Bernards Hospital Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1457958233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KITCHEN ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013135",
            "telephone_number": "870-972-4777",
            "fax_number": "870-972-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KITCHEN ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013135",
            "telephone_number": "870-972-4777",
            "fax_number": "870-972-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KAITLYN",
        "middle_name": "SOFFRAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "212541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Sills
• Joy Sills, NP
• Silver Lining Counseling LLC
• Kayla Silvey
• Dalfoney Simmons
• Rachel Simmons
• Steve Simmons
• Emily Simon
• Bridgette E Simone, LPE
• Tina Simons, LMSW

• Family Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.