Individual provider Active NPI

Tyler D Simmons, D.C.

  • Chiropractor
  • Winchester, KY
National Provider Identifier
1588058762
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
249094 Issued in KY
Practice address
29 Canary LN
Winchester, KY 40391
Phone
(859) 744-7319
Fax
(859) 744-7319
NPI assigned
Mar 25, 2015
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5457 KY
Chiropractor 111N00000X 249094 KY Primary

Addresses

Primary practice location

29 Canary LN
Winchester, KY 40391

Mailing address

29 Canary LN
Winchester, KY 40391-1645
Phone (859) 744-7319

Other practice location 1

140 Redwing Dr
Winchester, KY 40391
Phone (859) 744-7319

Other practice location 2

197 E Brannon Rd
Nicholasville, KY 40356-8060
Phone (859) 971-0370

Other identifiers 1

IdentifierTypeStateIssuer
861128239MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915002611 KY Practitioner - Chiropractic 0941596019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29 Canary LN
Winchester, KY 40391-1645
Phone (859) 744-7319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249094KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Man O War Urgent Care LLC CurrentSince Apr 21, 2024 Accepting new patients
Barnes Family Chiropractic Inc Chiropractor CurrentSince Jul 7, 2018 Accepting new patients

Locations

197 E Brannon Rd
Nicholasville, KY 40356
Phone (859) 523-5310

140 Redwing Dr
Winchester, KY 40391
Phone (859) 744-7319

29 Canary Ln
Winchester, KY 40391
Phone (859) 744-7319

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1588058762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911645",
            "telephone_number": "859-744-7319",
            "fax_number": "859-744-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CANARY LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "40391",
            "telephone_number": "859-744-7319",
            "fax_number": "859-744-7319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Redwing Dr",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "KY",
            "postal_code": "40391",
            "country_code": "US",
            "telephone_number": "859-744-7319",
            "fax_number": "859-744-7319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "197 E Brannon Rd",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403568060",
            "country_code": "US",
            "telephone_number": "859-971-0370",
            "fax_number": "859-971-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TYLER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5457",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "249094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861128239",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.