Active NPI
Scotty Simmons
- Driver
- Milledgeville, GA
National Provider Identifier
1467066712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 320 Cicada Dr SE
Milledgeville, GA 31061-5941 - Phone
- (912) 424-4467
- NPI assigned
- Sep 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | GA | Primary |
Addresses
Primary practice location
320 Cicada Dr SE
Milledgeville, GA 31061-5941
Mailing address
320 Cicada Dr SE
Milledgeville, GA 31061-5941
Phone (912) 424-4467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Milledgeville | Direct |
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": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1467066712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 CICADA DR SE",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310615941",
"telephone_number": "912-424-4467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 CICADA DR SE",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310615941",
"telephone_number": "912-424-4467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "SCOTTY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-03",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NA",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Milledgeville",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "320 Cicada Dr SE",
"city": "Milledgeville",
"state": "GA",
"country_code": "US",
"postal_code": "310615941",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.