Individual provider Active NPI

Sheryl L Simkins, PT PCS

  • Pediatric Physical Therapist
  • Bozeman, MT
National Provider Identifier
1710969878
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
712PT Issued in MT
Practice address
612 E Main St
Ste C
Bozeman, MT 59715-3726
Phone
(406) 522-3722
Fax
(406) 522-0018
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 712PT MT
Pediatric Physical Therapist 2251P0200X 712PT MT Primary
Orthotic Fitter 225000000X 712PT MT

Addresses

Primary practice location

612 E Main St
Ste C
Bozeman, MT 59715-3726

Mailing address

612 E Main St
Ste C
Bozeman, MT 59715-3726
Phone (406) 522-3722

Other identifiers 2

IdentifierTypeStateIssuer
5606515MedicaidMT
0349520MedicaidMT

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
712PTMTMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1710969878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E MAIN ST",
            "address_2": "STE C",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153726",
            "telephone_number": "406-522-3722",
            "fax_number": "406-522-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E MAIN ST",
            "address_2": "STE C",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153726",
            "telephone_number": "406-522-3722",
            "fax_number": "406-522-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMKINS",
        "first_name": "SHERYL",
        "middle_name": "L",
        "credential": "PT PCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "712PT",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MT",
            "license": "712PT",
            "primary": true
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "MT",
            "license": "712PT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5606515",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0349520",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.