NPIMap

Individual provider Active NPI

Jennifer Simon, FNP-C

  • Family Nurse Practitioner
  • Humble, TX
National Provider Identifier
1659902054
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01200072 Issued in TX
Practice address
11411 N Sam Houston Pkwy E Ste 146
Humble, TX 77396-5903
Phone
(832) 781-4340
NPI assigned
Feb 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01200072 TX Primary

Addresses

Primary practice location

11411 N Sam Houston Pkwy E Ste 146
Humble, TX 77396-5903

Mailing address

11411 N Sam Houston Pkwy E Ste 146
Humble, TX 77396-5903

Other identifiers 1

IdentifierTypeStateIssuer
F01200072OtherTXFNP BOARD CERTIFICATION

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL getwellwalkinclinic@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413001514 TX Practitioner - Nurse Practitioner 8224446299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 Swift St
Refugio, TX 78377-2425
Phone 3615262321138

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F01200072TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Refugio County Memorial Hospital District CurrentSince Nov 6, 2023 Accepting new patients
Refugio County Memorial Hospital District CurrentSince Nov 6, 2023 Accepting new patients
Get Well Healthcare Services Family CurrentSince Jan 1, 2021 Accepting new patients
Get Well at Home Care Agency CurrentSince Jul 19, 2020 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Refugio County Memorial Hospital District Past Accepting new patients
Refugio County Memorial Hospital District Past Accepting new patients

Locations

11411 N Sam Houston Pkwy E
Ste 146
Humble, TX 77396
Phone (832) 781-4340

1420 FM 1960 Bypass Rd E
Ste 122
Humble, TX 77338
Phone (281) 540-2225

107 Swift St
Refugio, TX 78377
Phone (361) 526-2321

Interoperability endpoints

  • Direct secure messaging: jennifer.simon.1@6815.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/7f96711f-afb0-4764-969a-c5d57fe30c59/

Organizations & group practices 7

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 2

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1659902054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 N SAM HOUSTON PKWY E STE 146",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773965903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 N SAM HOUSTON PKWY E STE 146",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773965903",
            "telephone_number": "832-781-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F01200072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP BOARD CERTIFICATION",
            "identifier": "F01200072",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "getwellwalkinclinic@gmail.com",
            "affiliation": "N",
            "address_1": "11411 N Sam Houston Pkwy E Ste 146",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773965903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.