Individual provider Active NPI

David RW Simmons, M.D.

  • Specialist
  • Maitland, FL
National Provider Identifier
1790787901
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0066766 Issued in FL
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

Updated by the provider on Aug 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
376186000MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
ME0066766FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Inpatient Medicine LLC CurrentSince Aug 20, 2017 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.

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

Verify at the official NPI Registry.