Jacqueline Deborah Simon, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN9328821 Issued in FL

Practice address

2382 NE 29TH St
Lighthouse Point, FL 33064-8131

Phone

(954) 540-6547

Fax

(949) 695-4648

NPI assigned

Aug 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1497200307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2091 NE 36TH ST UNIT 51838",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330742606",
            "telephone_number": "954-540-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 NE 29TH ST",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330648131",
            "telephone_number": "954-540-6547",
            "fax_number": "949-695-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JACQUELINE",
        "middle_name": "DEBORAH",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9328821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lady Michelle Servillas, PT
• Omid M Seylabi, MD
• John F Shaw, M.D.
• Eileen M Shea, RBT
• Sophonie Simeon
• Andrew E Slatkow, DC
• Cristel Sledd
• Sherine Smith
• South Florida Medical Centers Inc
• Stacy Spicer

• Psychiatric/Mental Health Nurse Practitioner in Lighthouse Point, FL
• Providers in Lighthouse Point, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.