Axonos Medical Group PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

AXONOS MEDICAL GROUP PLLC

Practice address

209 Saint Louis Ave Ste 100
Fort Worth, TX 76104-1279

Phone

(817) 294-0934

NPI assigned

Mar 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Steven Simmons, DONPI 1104815505

Title

Owner

Phone

(817) 294-0934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hayleyesus Paulos Gulilat, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1316310170
  Medicare reassignment NPD
• Riley Johnson, DO

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1366939779
  Medicare reassignment NPD
• David T Gonzales, PA

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1588766919
  Medicare reassignment
• Steven Lee Simmons, D.O.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1104815505
  NPD (past) Authorized official

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1760182448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SAINT LOUIS AVE STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SAINT LOUIS AVE STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041279",
            "telephone_number": "817-294-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXONOS MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-294-0934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhishek Avirineni, MD
• Awal 2012 Opco, LLC
• Grace Elizabeth Awbrey, RBT
• Awesome Always LLC
• Susan Awwad
• Dan Alan Axthelm, M.D.
• Julie Kay Ayala, LPC
• Tania Ayala, APRN-CNP
• David Ayaram, MD
• Ayesha Kanwal DO PLLC

• Interventional Pain Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.