Individual provider Active NPI

Jessica M Simon

  • Nurse Practitioner
  • Waco, TX
National Provider Identifier
1538721246
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP142254 Issued in TX
Practice address
3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144
Phone
(254) 741-6641
NPI assigned
Jul 2, 2019
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F06191496 TX
Nurse Practitioner 363L00000X AP142254 TX Primary

Addresses

Primary practice location

3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144

Mailing address

2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone (512) 244-4272

Other practice location 1

3613 Trice Ave
Waco, TX 76707-1127
Phone (254) 224-8077

Other identifiers 1

IdentifierTypeStateIssuer
405277101MedicaidTX

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191118001481 TX Practitioner - Nurse Practitioner 6204268931 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arete Urgent Care PLLCGroup PAC ID 6507042876, 9 clinicians

Practice addresses (Care Compare)

401 E Milam St
Mexia, TX 76667-2329
Phone (254) 562-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP142254TXMDNurse Practitioner
F06191496TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Aug 3, 2022 Accepting new patients
Sierra Healthcare Network LLC CurrentSince May 1, 2021 Accepting new patients
QV Urgent Care TX PLLC CurrentSince Jun 15, 2022 Accepting new patients
Arete Urgent Care, PLLC CurrentSince Mar 12, 2021 Accepting new patients
QV Urgent Care TX PLLC CurrentSince Jun 15, 2022 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Central Texas Neurological Association Past Accepting new patients
Mark Malone MD PA Past Accepting new patients
Chest Diagnostic Therapeutic SVCS & Transit Nursing of TX, Inc PastSince Mar 12, 2021 Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

2727 Lyndon B Johnson Fwy
Ste 2129
Dallas, TX 75234
Phone (214) 935-5777

1600 US Highway 79 S
Henderson, TX 75654
Phone (903) 657-9571

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

401 E Milam St
Mexia, TX 76667
Phone (254) 562-2500

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

Interoperability endpoints

  • Direct secure messaging: ms_jsimon66@landmarkhealth-direct.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1538721246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HILLCREST DR STE 1",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083144",
            "telephone_number": "254-741-6641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3613 Trice Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767071127",
            "country_code": "US",
            "telephone_number": "254-224-8077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "F06191496",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP142254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405277101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.