Douglas A Simmons, FNP
Individual provider Active NPI Family Nurse Practitioner · Bisbee, AZ
NPI 1780813832 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1780813832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP4820 (AZ)
- Practice address
- 108 Arizona St
Bisbee, AZ 85603-1804 - Phone
- (520) 432-3309
- Fax
- (520) 364-4261
- NPI assigned
- Jul 10, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130726000679 | AZ | Practitioner - Nurse Practitioner | 8123269594 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bisbee Hospital Association | Current |
Accepting new patients | |
| Bisbee Hospital Association | Current |
Accepting new patients | |
| Bisbee Hospital Association | Current | Accepting new patients |
Locations
101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383
100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659
4524 E Hereford Rd
Ste 1
Hereford, AZ 85615
4524 E Hereford Rd
Hereford, AZ 85615
Phone (520) 803-1108
10524 E Highway 92
Hereford, AZ 85615
Phone (520) 366-0300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP4820 | AZ | Yes |
Addresses
Primary practice location
108 Arizona St
Bisbee, AZ 85603-1804
Mailing address
1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 364-6852
Other providers in Bisbee, AZ
- Safeway Inc
- Melissa Marie Sanchez
- Sassy Transport LLC
- Alexander L. Schoenfeld
- Julie Schourup
- Scott V Slagis
- Richard Roland Snure
- Speak With US Inc
- Speak With US, Inc.
- Brad Thayer
All providers in Bisbee, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.