Sheran Maxwell Simo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

004573 Issued in CT

Practice address

267 Grant St
Bridgeport, CT 06610-2805

Phone

(203) 384-3042

NPI assigned

Sep 20, 2005

Sex

Female

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

Nurse Practitioner

State licenses

Practice roles

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.

• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1992924633

  Family

  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1497740062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MILL HILL AVE",
            "address_2": "3RD FLOOR",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102826",
            "telephone_number": "203-384-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMO",
        "first_name": "SHERAN",
        "middle_name": "MAXWELL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000703A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S92390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Silva, MS, LPC
• Maryellen Silva, NP
• Hugo Silveira E Silva, DPT
• Mark T Silvestri, M.D.
• Peta-Gay Natalie Simmonds-Carroo, CNA
• Andrew Craig Simon, O.D.
• Simplemente Seres Inspirados Servicio En Casa
• Corie Simpson
• Gina Levon Simpson
• Pamela Simpson

• Family Nurse Practitioner in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.