Active NPI
Melvin W Simmons, O.D.
- Optometrist
- Vergennes, VT
National Provider Identifier
1679689491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0300000146
- Practice address
- 27 Main St
Vergennes, VT 05491-1113 - Phone
- (802) 877-2422
- Fax
- (802) 877-1124
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0300000146 | VT | Primary |
Addresses
Primary practice location
27 Main St
Vergennes, VT 05491-1113
Mailing address
27 Main St
Vergennes, VT 05491-1113
Phone (802) 877-2422
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344472 | Other | COMBINED INSURANCE CO | |
| 0007946 | Medicaid | VT | |
| 59V003 | Other | MVP | |
| 7946 | Other | BLUE CROSS BLUE SHIELD | |
| 83870 | Other | DAVIS VISION/G.E. |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0300000146 | VT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialeyes Professional Eye Care Services, PLLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Vergennes, VT
- NPI 1790917102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679689491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 MAIN ST",
"city": "VERGENNES",
"state": "VT",
"postal_code": "054911113",
"telephone_number": "802-877-2422",
"fax_number": "802-877-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 MAIN ST",
"city": "VERGENNES",
"state": "VT",
"postal_code": "054911113",
"telephone_number": "802-877-2422",
"fax_number": "802-877-1124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "MELVIN",
"middle_name": "W",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VT",
"license": "0300000146",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMBINED INSURANCE CO",
"identifier": "344472",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007946",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "59V003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7946",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION/G.E.",
"identifier": "83870",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Vergennes, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.