Idella Simmons MD Family Medicine LLC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

01050509A Issued in IN

Legal business name

IDELLA SIMMONS MD FAMILY MEDICINE LLC

Practice address

950 N Alabama St
Indianapolis, IN 46202-3350

Phone

(317) 916-9946

Fax

(317) 916-9979

NPI assigned

Mar 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Idella N Simmons, M.D.

Title

Owner

Phone

(317) 916-9946

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1700056058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N ALABAMA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023350",
            "telephone_number": "317-916-9946",
            "fax_number": "317-916-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N ALABAMA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023350",
            "telephone_number": "317-916-9946",
            "fax_number": "317-916-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDELLA SIMMONS MD FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "IDELLA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-916-9946",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "IN",
            "license": "01050509A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Legal Medicine in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.