Simon B Small, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC001870-L Issued in PA

Practice address

327 Montgomery Ave
Bala Cynwyd, PA 19004-2815

Phone

(610) 664-0848

Fax

(610) 664-7707

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bala Podiatry Associates

  • Podiatrist
  • Bala Cynwyd, PA
  • NPI 1225234222
  NPD (past) Authorized official
• Pro Support Systems

  • Podiatrist
  • Bala Cynwyd, PA
  • NPI 1922241934
  NPD (past) Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790806909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 MONTGOMERY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042815",
            "telephone_number": "610-664-0848",
            "fax_number": "610-664-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MONTGOMERY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042815",
            "telephone_number": "610-664-0848",
            "fax_number": "610-664-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "SIMON",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001870-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NUMBER",
            "identifier": "184993",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Kay Sit, MD
• Anastasia Skliros, PSYD
• SKR Wellness LLC
• Kelly J Slothower, DPT
• Sarah Small
• Georgetta Smith, MS
• Maasi Jacob Smith, DPM
• Ann Smolen, LCSW, PHD
• Ashley Annette Snoke, RDN
• Qianna Snooks, PSYD

• Podiatrist in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.