Wylene B Simmons-Ellington, LICENSED MIDWIFE

Primary specialty

Lay MidwifeTaxonomy code 175M00000X

License

MW122 Issued in FL

Practice address

2331 N State Road 7 Ste 124
Lauderdale Lakes, FL 33313-3771

Phone

(954) 484-7698

NPI assigned

Oct 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Wylene B Simmons Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1639358716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 N STATE ROAD 7 STE 124",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333133771",
            "telephone_number": "954-484-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 N STATE ROAD 7 STE 124",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333133771",
            "telephone_number": "954-484-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS-ELLINGTON",
        "first_name": "WYLENE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LICENSED MIDWIFE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "FL",
            "license": "MW122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "Y4971",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340135900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WYLENE",
            "last_name": "SIMMONS",
            "middle_name": "B",
            "prefix": "MRS.",
            "credential": "LICENSED MIDWIFE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lay Midwife in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Lay Midwife in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.