Individual provider Active NPI

Susan Lynne Simmons, RN, LMT

  • Nurse Massage Therapist (NMT)
  • St Petersburg, FL
National Provider Identifier
1669655544
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X
License
1189282 RN 27486 MA Issued in FL
Practice address
3206 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-1202
Phone
(727) 822-8400
Fax
(727) 822-8400
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Massage Therapist (NMT) 163WM1400X 1189282 RN 27486 MA FL Primary

Addresses

Primary practice location

3206 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-1202

Mailing address

3206 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-1202
Phone (727) 822-8400

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1189282 RN 27486 MAFLMDNurse Massage Therapist (NMT)

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1669655544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041202",
            "telephone_number": "727-822-8400",
            "fax_number": "727-822-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041202",
            "telephone_number": "727-822-8400",
            "fax_number": "727-822-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SUSAN",
        "middle_name": "LYNNE",
        "credential": "RN, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "FL",
            "license": "1189282 RN  27486 MA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.