Shalom Charisse Simmons, AGACNP-BC MSN, RN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

431902 Issued in NY

Practice address

129 Macdonough St Apt 4R
Brooklyn, NY 11216-2517

Phone

(718) 541-4132

NPI assigned

Jul 2, 2021

Last updated

Jul 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spectrum Care Group

  • Acute Care Nurse Practitioner
  • Brooklyn, NY
  • NPI 1184598583
  NPD Authorized official

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1700457611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MACDONOUGH ST APT 4R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162517",
            "telephone_number": "718-541-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MACDONOUGH ST APT 4R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162517",
            "telephone_number": "718-541-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SHALOM",
        "middle_name": "CHARISSE",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wan",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "129 MacDonough St Apt 4R",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112162517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Manasseh Simmons
• Michael K Simmons Jr., MD
• Nyla Simmons
• Ricardo D Simmons
• Robyn Simmons
• Sharon Simmons, AGNP
• Tristen Simmons
• Troy Desmond Simmons Jr., MSN
• Yvonne Simmons, LPN
• Zaire Simmons

• Acute Care Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.