Active NPI
Bryan Paul Simmons, MD
- Infectious Disease Physician
- Memphis, TN
National Provider Identifier
1619971637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- MD 15503
- Practice address
- 176 S Bellevue Blvd
Suite 603
Memphis, TN 38104-3424 - Phone
- (901) 516-8231
- Fax
- (901) 516-8249
- NPI assigned
- Jun 8, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MD 15503 | TN | Primary |
Addresses
Primary practice location
176 S Bellevue Blvd
Suite 603
Memphis, TN 38104-3424
Mailing address
176 S Bellevue Blvd
Suite 603
Memphis, TN 38104-3424
Phone (901) 516-8231
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E0615 | Other | AR | AR LICENSE |
| 3020692 | Medicaid | TN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 15503 | TN | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1619971637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176 S BELLEVUE BLVD",
"address_2": "SUITE 603",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381043424",
"telephone_number": "901-516-8231",
"fax_number": "901-516-8249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 S BELLEVUE BLVD",
"address_2": "SUITE 603",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381043424",
"telephone_number": "901-516-8231",
"fax_number": "901-516-8249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "BRYAN",
"middle_name": "PAUL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-08",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "TN",
"license": "MD 15503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR LICENSE",
"identifier": "E0615",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3020692",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.