Individual provider Active NPI

Rhonda Simmons, LCSW

  • Clinical Social Worker
  • Picayune, MS
National Provider Identifier
1508081712
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C5770 Issued in MS
Practice address
1839 Cooper Rd Ste D
Picayune, MS 39466-2836
Phone
(601) 749-9477
Fax
(601) 749-0605
NPI assigned
Apr 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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 C5770 MS Primary

Addresses

Primary practice location

1839 Cooper Rd Ste D
Picayune, MS 39466-2836

Mailing address

23405 Indian Ridge Rd
Picayune, MS 39466-8950
Phone (601) 749-9477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100709000310 MS Practitioner - Clinical Social Worker 4981739273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1839 Cooper Rd
Suite D
Picayune, MS 39466-2836
Phone (601) 749-9477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rhonda Sanders, LCSW, LLC CurrentSince Oct 16, 2009 Accepting new patients

Locations

703 W Canal St
Picayune, MS 39466
Phone (601) 749-9477

1839 Cooper Rd
Ste D
Picayune, MS 39466
Phone (601) 749-9477

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1508081712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23405 INDIAN RIDGE RD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394668950",
            "telephone_number": "601-749-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 COOPER RD STE D",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394662836",
            "telephone_number": "601-749-9477",
            "fax_number": "601-749-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "RHONDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-14",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Picayune, MS

Sources for this page

Verify at the official NPI Registry.