Individual provider Active NPI

John T. Simmons Jr., LVN

  • Case Manager/Care Coordinator
  • Anaheim, CA
National Provider Identifier
1790444602
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
5020 E Holbrook St
Anaheim, CA 92807-1103
Phone
(714) 261-5392
NPI assigned
Dec 8, 2021
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 281328 CA
Community Health Worker 172V00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

5020 E Holbrook St
Anaheim, CA 92807-1103

Mailing address

5020 E Holbrook St
Anaheim, CA 92807-1103
Phone (714) 261-5392

Other practice location 1

10510 S Vermont Ave
Los Angeles, CA 90044-3022
Phone (323) 676-1000

Other practice location 2

10900 S Vermont Ave
Los Angeles, CA 90044-3016
Phone (323) 676-1000

Other practice location 3

4111 E Wilton St
Long Beach, CA 90804-2109
Phone (714) 464-2967

Other practice location 4

1720 Termino Ave
Long Beach, CA 90804-2104
Phone (714) 464-2967

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
281328CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Case Management Integrated Solutions, LLC Case Manager/Care Coordinator PastSince May 16, 2021 Accepting new patients

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1790444602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 E HOLBROOK ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071103",
            "telephone_number": "714-261-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 E HOLBROOK ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071103",
            "telephone_number": "714-261-5392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10510 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900443022",
            "country_code": "US",
            "telephone_number": "323-676-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10900 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900443016",
            "country_code": "US",
            "telephone_number": "323-676-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4111 E Wilton St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908042109",
            "country_code": "US",
            "telephone_number": "714-464-2967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 Termino Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908042104",
            "country_code": "US",
            "telephone_number": "714-464-2967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOHN",
        "middle_name": "T.",
        "name_suffix": "Jr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "281328",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.