Rustico V Simpelo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33913 Issued in MO

Practice address

108 Frizzell St
Potosi, MO 63664-1505

Phone

(573) 438-5408

Fax

(573) 438-2419

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1477537801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTHWAY",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641420",
            "telephone_number": "573-438-5408",
            "fax_number": "573-438-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 FRIZZELL ST",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641505",
            "telephone_number": "573-438-5408",
            "fax_number": "573-438-2419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPELO",
        "first_name": "RUSTICO",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "33913",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "33913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597954205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Selbert, LPC
• Seth Paskon M.D.
• Rackel Elizabeth Sexton-Alfaro, LCSW
• Simpelo Medi-Spa
• Simpelo Medical Clinic, P.C.
• Brett T Snodgrass, MD
• Southtowne Imaging Center LLC
• Matthew Scott Standridge, D.D.S.
• Vonna Suda, EDS
• Bobbi J Summers, LPC

• Family Medicine Physician in Potosi, MO
• Providers in Potosi, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.