Individual provider Active NPI

James Michael Simmons, PT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1760500342
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006779 Issued in WA
Practice address
1127 Tieton Dr
Yakima, WA 98902-3851
Phone
(509) 469-7474
Fax
(509) 469-7575
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00006779 WA Primary

Addresses

Primary practice location

1127 Tieton Dr
Yakima, WA 98902-3851

Mailing address

1127 Tieton Dr
Yakima, WA 98902-3851
Phone (509) 469-7474

Other identifiers 3

IdentifierTypeStateIssuer
8344731MedicaidWA
134660OtherWALABOR & INDUSTRIES
SI3720OtherWAREGENCE BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000646 WA Practitioner - Physical Therapist in Private Practice 5193624252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1127 Tieton Dr
Yakima, WA 98902-3851
Phone (509) 469-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00006779WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Washington Physical Therapy Physical Therapist CurrentSince Oct 18, 1999 Accepting new patients

Locations

1127 Tieton Dr
Yakima, WA 98902
Phone (509) 469-7474

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760500342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023851",
            "telephone_number": "509-469-7474",
            "fax_number": "509-469-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023851",
            "telephone_number": "509-469-7474",
            "fax_number": "509-469-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8344731",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "134660",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "SI3720",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.