Individual provider Active NPI

William John Simons, M.D.

  • Psychiatry Physician
  • Eau Claire, WI
National Provider Identifier
1790778801
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
69540 Issued in WI
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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
65.92 of 100Reported as group
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
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20040616001307 NC Practitioner - PsychiatryPractitioner - Internal Medicine 1153305149 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0000-18058NCMDPsychiatry Physician
18058NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jun 8, 2021 Accepting new patients
NHCS Physicians Inc Psychiatry CurrentSince Jul 22, 2022 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatry PastSince Dec 11, 2012 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)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0000-18058 NC
Psychiatry Physician 2084P0800X 69540 WI Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
8976313MedicaidNC
76313OtherNCBCBS
P00341710OtherRAILROAD 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

Verify at the official NPI Registry.