Individual provider Active NPI

Jasmine Simmons, OTR

  • Occupational Therapist
  • Avon, IN
National Provider Identifier
1467084061
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31007079A Issued in IN
Practice address
114 N Avon Ave
Avon, IN 46123-8475
Phone
(317) 272-4100
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31007079A IN Primary

Addresses

Primary practice location

114 N Avon Ave
Avon, IN 46123-8475

Mailing address

6515 Tampa LN
Indianapolis, IN 46241-7637
Phone (224) 221-7628

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

State licenses

LicenseStateTypeSpecialty
31007079AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews Chiropractic and Rehabilitation CurrentSince Feb 16, 2020 Accepting new patients
Spinalcare Physical Medicine LLC PastSince Feb 16, 2020 Accepting new patients

Locations

114 N Avon Ave
Avon, IN 46123
Phone (317) 272-4100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1467084061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 TAMPA LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462417637",
            "telephone_number": "224-221-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N AVON AVE",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238475",
            "telephone_number": "317-272-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JASMINE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007079A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.