Active NPI
Tina Denise Simmons
- Clinical Social Worker
- Riverview, FL
National Provider Identifier
1619698453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16675
- Practice address
- 13209 Fawn Lily Dr
Riverview, FL 33579-0009 - Phone
- (443) 956-9675
- NPI assigned
- Sep 9, 2022
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16675 | FL | Primary |
Addresses
Primary practice location
13209 Fawn Lily Dr
Riverview, FL 33579-0009
Mailing address
James a Haley VA
1300 Bruce B Downs Blvd
Tampa, FL 33612
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16675 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1619698453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "JAMES A HALEY VA",
"address_2": "1300 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "33612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13209 FAWN LILY DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335790009",
"telephone_number": "443-956-9675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "TINA",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "16675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.