Active NPI
Thela D Simmons, O.D.
- Optometrist
- Pampa, TX
National Provider Identifier
1609983337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1971T
- Practice address
- 1324 N Banks St
Pampa, TX 79065-4106 - Phone
- (806) 665-0771
- Fax
- (806) 665-3511
- NPI assigned
- Aug 25, 2006
- Last updated
- Apr 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1971T | TX | Primary |
Addresses
Primary practice location
1324 N Banks St
Pampa, TX 79065-4106
Mailing address
PO Box 2237
Pampa, TX 79066-2237
Phone (806) 665-0771
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4628101 | Other | TX | AETNA |
| 80327E | Other | TX | BLUE CROSS BLUE SHIELD |
| 020190701 | Medicaid | TX | |
| 124055100 | Other | TX | S.W. LIFE AND HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1971T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Simmons and Simmons, PA | Optometrist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Pampa, TX
- NPI 1942351895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1609983337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2237",
"city": "PAMPA",
"state": "TX",
"postal_code": "790662237",
"telephone_number": "806-665-0771",
"fax_number": "806-665-3511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 N BANKS ST",
"city": "PAMPA",
"state": "TX",
"postal_code": "790654106",
"telephone_number": "806-665-0771",
"fax_number": "806-665-3511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "THELA",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "1971T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4628101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "80327E",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020190701",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "S.W. LIFE AND HEALTH",
"identifier": "124055100",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pampa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.