Individual provider Active NPI

Brittany Root Simon

  • Primary Care Nurse Practitioner
  • Rock Hill, SC
National Provider Identifier
1639878895
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
27136 Issued in SC
Practice address
370 Herlong Ave S Ste 200
Rock Hill, SC 29732-1160
Phone
(803) 980-5864
Fax
(803) 980-5817
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 27136 SC Primary

Addresses

Primary practice location

370 Herlong Ave S Ste 200
Rock Hill, SC 29732-1160

Mailing address

370 Herlong Ave S Ste 200
Rock Hill, SC 29732-1160
Phone (803) 980-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230502000958 SC Practitioner - Nurse Practitioner 5193180842 Reassigns benefits to 1 organization
I20260616001380 NC Practitioner - Nurse Practitioner 5193180842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Pulmonary and Critical Care LLCGroup PAC ID 0749440543, 5 clinicians

Practice addresses (Care Compare)

370 Herlong Ave S
Suite 200
Rock Hill, SC 29732-1160
Phone (803) 980-5864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
27136SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Pulmonary and Critical Care LLC CurrentSince Apr 14, 2023 Accepting new patients

Locations

370 Herlong Ave S
Ste 200
Rock Hill, SC 29732
Phone (803) 980-5864

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3719/brand/1/csg/1/fhir/r4
  • Direct secure messaging: brittany.simon.1@34062.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1639878895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 HERLONG AVE S STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321160",
            "telephone_number": "803-980-5864",
            "fax_number": "803-980-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 HERLONG AVE S STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321160",
            "telephone_number": "803-980-5864",
            "fax_number": "803-980-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "BRITTANY",
        "middle_name": "ROOT",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "27136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.