Individual provider Active NPI

Mark Allen Simmons, MSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1487703443
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14904 Issued in TX
Practice address
7272 Wurzbach Rd Ste 1504
San Antonio, TX 78240-4805
Phone
(210) 647-7907
Fax
(210) 647-7805
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14904 TX Primary

Addresses

Primary practice location

7272 Wurzbach Rd Ste 1504
San Antonio, TX 78240-4805

Mailing address

7272 Wurzbach Rd Ste 1504
San Antonio, TX 78240-4805
Phone (210) 647-7907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111230000550 TX Practitioner - Clinical Social Worker 4688840325 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7272 Wurzbach
Suite 1504
San Antonio, TX 78240-4805
Phone (210) 347-7907

7272 Wurzbach Rd
Suite 1504
San Antonio, TX 78240-4805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14904TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1487703443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD STE 1504",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404805",
            "telephone_number": "210-647-7907",
            "fax_number": "210-647-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD STE 1504",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404805",
            "telephone_number": "210-647-7907",
            "fax_number": "210-647-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "14904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.