Organization Active NPI

Nancy Simons Ling MD PA

  • Dermatology Physician
  • Brandon, FL
National Provider Identifier
1659698371
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0046345 Issued in FL
Legal business name
NANCY SIMONS LING MD PA
Practice address
305 Bryan Rd
Suite 5 & 6
Brandon, FL 33511-5340
Phone
(813) 689-2054
Fax
(813) 654-5640
NPI assigned
Apr 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Ms. Dianna L Brick
Title
Practice Manager
Phone
(813) 689-2054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME0046345 FL Primary

Addresses

Primary practice location

305 Bryan Rd
Suite 5 & 6
Brandon, FL 33511-5340

Mailing address

305 Bryan Rd
Suite 5 & 6
Brandon, FL 33511-5340
Phone (813) 689-2054

Other identifiers 1

IdentifierTypeStateIssuer
CH9887OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126001110 FL Part B Supplier - Clinic/Group Practice 8224217989 Receives reassigned benefits from 2 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

305 Bryan Rd
Ste 5
Brandon, FL 33511
Phone (813) 689-2054

305 Bryan Rd
Ste 56
Brandon, FL 33511
Phone (813) 689-2054

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1659698371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BRYAN RD",
            "address_2": "SUITE 5 & 6",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115340",
            "telephone_number": "813-689-2054",
            "fax_number": "813-654-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BRYAN RD",
            "address_2": "SUITE 5 & 6",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115340",
            "telephone_number": "813-689-2054",
            "fax_number": "813-654-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY SIMONS LING MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "BRICK",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "813-689-2054",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0046345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9887",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.