Individual provider Active NPI

Garrette Adrian Simmonds

  • Registered Nurse
  • Flushing, NY
National Provider Identifier
1790567741
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
811995-01 Issued in NY
Practice address
4376 163Rd St Apt 4D
Flushing, NY 11358-3267
Phone
(917) 500-7310
NPI assigned
Oct 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 811995-01 NY Primary

Addresses

Primary practice location

4376 163Rd St Apt 4D
Flushing, NY 11358-3267

Mailing address

4376 163Rd St Apt 4D
Flushing, NY 11358-3267
Phone (917) 500-7310

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
811995-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1790567741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4376 163RD ST APT 4D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583267",
            "telephone_number": "917-500-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4376 163RD ST APT 4D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583267",
            "telephone_number": "917-500-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONDS",
        "first_name": "GARRETTE",
        "middle_name": "ADRIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "811995-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.