Active NPI
David RW Simmons, M.D.
- Specialist
- Maitland, FL
National Provider Identifier
1790787901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME0066766
- Practice address
- 850 Trafalgar CT
Ste 420
Maitland, FL 32751-4141 - Phone
- (407) 478-0065
- Fax
- (407) 478-0085
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME0066766 | FL | Primary |
Addresses
Primary practice location
850 Trafalgar CT
Ste 420
Maitland, FL 32751-4141
Mailing address
850 Trafalgar CT
Ste 420
Maitland, FL 32751-4141
Phone (407) 478-0065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376186000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071217000543 | FL | Practitioner - Internal Medicine | 7810087699 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0066766 | FL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Inpatient Medicine LLC | Current | Accepting new patients | |
| Primary Care Specialists LLC | Past | Accepting new patients | |
| Internal Medicine Group | Past | Accepting new patients | |
| Florida Care Level Management Direct, LLC | Past | Accepting new patients |
Locations
525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1316976145
-
- Family Medicine Physician
- Orlando, FL
- NPI 1831395797
-
- General Practice Physician
- Calabasas, CA
- NPI 1770569220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1790787901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 TRAFALGAR CT",
"address_2": "STE 420",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514141",
"telephone_number": "407-478-0065",
"fax_number": "407-478-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 TRAFALGAR CT",
"address_2": "STE 420",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514141",
"telephone_number": "407-478-0065",
"fax_number": "407-478-0085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "DAVID",
"middle_name": "RW",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME0066766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "376186000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.