Kathleen Ann Simon, CDCA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

172735 Issued in OH

Practice address

964 N Market St
Lisbon, OH 44432-9363

Phone

(330) 424-1468

Fax

(330) 424-1787

NPI assigned

Feb 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Family Recovery Center

  • Community/Behavioral Health Agency
  • Lisbon, OH
  • NPI 1821053042
  NPD
• Family Recovery Center

  • Community/Behavioral Health Agency
  • Lisbon, OH
  • NPI 1740548155
  NPD (past)

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1780216002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444600294",
            "telephone_number": "234-567-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 N MARKET ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329363",
            "telephone_number": "330-424-1468",
            "fax_number": "330-424-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "104984",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "172735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ella M Shasteen
• Debra Shaw Batchelor
• Gabrielle Shimko
• Aaron Ray Shope, CPRS
• Zia Ahmed Sial, MD
• Maria Sizer
• Cheryl Smith, COTA/L
• Connie Smith
• Kathleen Keaggy Smith, MA CCC-SLP
• Mallory Smith

• Case Manager/Care Coordinator in Lisbon, OH
• Providers in Lisbon, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.