Active NPI
William John Simons, M.D.
- Psychiatry Physician
- Eau Claire, WI
National Provider Identifier
1790778801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 69540
- Practice address
- 1400 Bellinger St
Eau Claire, WI 54703-5222 - Phone
- (715) 838-3635
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
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.
-
- Psychiatry Physician
- Durham, NC
- NPI 1508803214
Psychiatry
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 65.92 of 100
- Quality
- 15.88
- Promoting interoperability
- 97
- Improvement activities
- 40
- Cost
- 73.02
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040616001307 | NC | Practitioner - Psychiatry | 1153305149 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000-18058 | NC | MD | Psychiatry Physician |
| 18058 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current | Accepting new patients | |
| NHCS Physicians Inc | Psychiatry | Current | Accepting new patients |
| Mindpath Care Centers, North Carolina, PLLC | Psychiatry | Past | Accepting new patients |
Locations
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199
2301 Medpark Dr
Rocky Mount, NC 27804
Phone (252) 443-9500
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0000-18058 | NC | |
| Psychiatry Physician | 2084P0800X | 69540 | WI | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1400 Bellinger St
Eau Claire, WI 54703-5222
Mailing address
4 Herman Avenue Ext
Suite C
Asheville, NC 28803-8100
Phone (828) 676-2960
Other practice location 1
4 Herman Avenue Ext
Suite C
Asheville, NC 28803-8100
Phone (828) 676-2960
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8976313 | Medicaid | NC | |
| 76313 | Other | NC | BCBS |
| P00341710 | Other | RAILROAD MEDICARE B |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 16, 2018.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1790778801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 HERMAN AVENUE EXT",
"address_2": "SUITE C",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288038100",
"telephone_number": "828-676-2960",
"fax_number": "949-862-1960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BELLINGER ST",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547035222",
"telephone_number": "715-838-3635"
}
],
"practiceLocations": [
{
"address_1": "4 Herman Avenue Ext",
"address_2": "Suite C",
"address_purpose": "LOCATION",
"city": "Asheville",
"state": "NC",
"postal_code": "288038100",
"country_code": "US",
"telephone_number": "828-676-2960",
"fax_number": "949-862-1960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMONS",
"first_name": "WILLIAM",
"middle_name": "JOHN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "0000-18058",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "69540",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8976313",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "76313",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE B",
"identifier": "P00341710",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.