Individual provider Active NPI

Nicole Lee Simon, NP

  • Family Nurse Practitioner
  • Augusta, ME
National Provider Identifier
1740539089
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP121085 Issued in ME
Practice address
15 E Chestnut St
Augusta, ME 04330-5736
Phone
(207) 626-1561
Fax
(207) 626-1849
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP121085 ME Primary

Addresses

Primary practice location

15 E Chestnut St
Augusta, ME 04330-5736

Mailing address

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20121207000284 ME Practitioner - Nurse Practitioner 6507018082 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP121085MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Oct 1, 2012 Accepting new patients
Mainegeneral Medical Center CurrentSince Oct 1, 2012 Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1740539089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP121085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.