Individual provider Active NPI

Vanydia Simon

  • Specialist
  • Malden, MA
National Provider Identifier
1710248158
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
S66285825 Issued in MA
Practice address
214 Commercial St
Malden, MA 02148-6716
Phone
(781) 321-0645
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X S66285825 MA Primary

Addresses

Primary practice location

214 Commercial St
Malden, MA 02148-6716

Mailing address

214 Commercial St
Malden, MA 02148-6716
Phone (781) 321-0645

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

LicenseStateTypeSpecialty
S66285825MAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1710248158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486716",
            "telephone_number": "781-321-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486716",
            "telephone_number": "781-321-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "VANYDIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "S66285825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.