Individual provider Active NPI

Elizabeth Simmons

  • Home Health Agency
  • Clarksville, TN
National Provider Identifier
1760867543
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
L000000016299 Issued in TN
Practice address
1860 Wilma Rudolph Blvd
Ste 103-B
Clarksville, TN 37040-6750
Phone
(931) 920-8425
Fax
(931) 378-7016
NPI assigned
Jul 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X L000000016299 TN Primary

Addresses

Primary practice location

1860 Wilma Rudolph Blvd
Ste 103-B
Clarksville, TN 37040-6750

Mailing address

1860 Wilma Rudolph Blvd
Ste 103-B
Clarksville, TN 37040-6750
Phone (931) 920-8425

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L000000016299TNMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Special Needs Home Health Care LLC Home Health CurrentSince Apr 5, 2002 Accepting new patients

Locations

1860 Wilma Rudolph Blvd
Ste 103B
Clarksville, TN 37040
Phone (931) 920-8425

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1760867543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 WILMA RUDOLPH BLVD",
            "address_2": "STE 103-B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406750",
            "telephone_number": "931-920-8425",
            "fax_number": "931-378-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 WILMA RUDOLPH BLVD",
            "address_2": "STE 103-B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406750",
            "telephone_number": "931-920-8425",
            "fax_number": "931-378-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "L000000016299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.