Individual provider Active NPI

Nicholas John Simms, ANP-BC, GNP-BC

  • Adult Health Nurse Practitioner
  • Bedford, MA
National Provider Identifier
1700183415
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2262228 Issued in MA
Practice address
200 Springs Rd
Bedford, MA 01730-1114
Phone
(781) 687-2260
NPI assigned
Feb 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2262228 MA Primary
Gerontology Nurse Practitioner 363LG0600X RN2262228 MA

Addresses

Primary practice location

200 Springs Rd
Bedford, MA 01730-1114

Mailing address

208 Edge Hill Rd
Milton, MA 02186-5310
Phone (617) 980-2889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000682 MA Order and Referring Only - Nurse Practitioner 3971772070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2262228MAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1700183415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 EDGE HILL RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021865310",
            "telephone_number": "617-980-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "ANP-BC, GNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2262228",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2262228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

Verify at the official NPI Registry.