Individual provider Active NPI

Beth Simons, MDA, RD, LD

  • Registered Dietitian
  • Eagan, MN
National Provider Identifier
1760057038
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3730 Issued in MN
Practice address
1185 Town Centre Dr Ste 205
Eagan, MN 55123-1370
Phone
(612) 871-1145
Fax
(612) 870-5491
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3730 MN Primary

Addresses

Primary practice location

1185 Town Centre Dr Ste 205
Eagan, MN 55123-1370

Mailing address

927 Churchill St W
Stillwater, MN 55082-6605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906000246 MN Practitioner - Registered Dietitian Or Nutrition Professional 8224412564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Medical Assistant

State licenses

LicenseStateTypeSpecialty
3730MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mngi Digestive Health, P.a. CurrentSince Sep 12, 2022 Accepting new patients

Locations

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: bethany.simonsrd.p1@direct.mngastro.nextgenshare.com

Organizations & group practices 1

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1760057038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 CHURCHILL ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR STE 205",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231370",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "BETH",
        "credential": "MDA, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.