Active NPI
Lucas Simmons, DO
- Student in an Organized Health Care Education/Training Program
- Indianapolis, IN
National Provider Identifier
1477257293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1130 W Michigan Street
Fesler Hall 204
Indianapolis, IN 46202-5209 - Phone
- (317) 274-0275
- NPI assigned
- Mar 27, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1477257293 | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1130 W Michigan Street
Fesler Hall 204
Indianapolis, IN 46202-5209
Mailing address
1130 W Michigan Street
Fesler Hall 204
Indianapolis, IN 46202-5209
Phone (317) 274-0275
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230714001531 | IN | Order and Referring Only - Internal Medicine | 1153781703 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1477257293 | IN | MD | Internal Medicine Physician |
Interoperability endpoints
- lsimmons566071@direct.parkviewexchange.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715904000000",
"number": "1477257293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 W MICHIGAN STREET",
"address_2": "FESLER HALL 204",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025209",
"telephone_number": "317-274-0275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 W MICHIGAN STREET",
"address_2": "FESLER HALL 204",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025209",
"telephone_number": "317-274-0275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "LUCAS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-27",
"last_updated": "2024-05-17",
"certification_date": "2024-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "1477257293",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.