William R Simon Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-00201 Issued in KS

Practice address

2230 N Ridge Rd
Wichita, KS 67205-1053

Phone

(316) 448-8339

Fax

(316) 221-7149

NPI assigned

Oct 19, 2006

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Kansas Medical Center

  dba St Rose Family Medicine & Urgent Care Clinic

  • Family Medicine Physician
  • Great Bend, KS
  • NPI 1043556400
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1578645594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 N RIDGE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051053",
            "telephone_number": "316-448-8339",
            "fax_number": "316-221-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N RIDGE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051053",
            "telephone_number": "316-448-8339",
            "fax_number": "316-221-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "796",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-00201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard E Simon
• Theresa L Simon, CPTA
• Tonya Simon, RN
• Troy Simon, DO
• William C Simon, D.O.
• Aleena Simonds, APRN
• Marcia Simoneau, LSCSW
• Fara E Simons, CRNA
• Simply Authentic Therapy, LLC
• Simply Be Therapy, LLC

• Physician Assistant in Wichita, KS
• Providers in Wichita, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.