Individual provider Active NPI

Joe Louis Simmons, R.PH

  • Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1669726840
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
28297 Issued in TX
Practice address
4735 E Lancaster Ave
Fort Worth, TX 76103-3835
Phone
(817) 413-0545
Fax
(817) 413-0570
NPI assigned
Nov 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 28297 TX Primary

Addresses

Primary practice location

4735 E Lancaster Ave
Fort Worth, TX 76103-3835

Mailing address

4735 E Lancaster Ave
Fort Worth, TX 76103-3835
Phone (817) 413-0545

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
28297TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1669726840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033835",
            "telephone_number": "817-413-0545",
            "fax_number": "817-413-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033835",
            "telephone_number": "817-413-0545",
            "fax_number": "817-413-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOE",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "28297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.