Individual provider Active NPI

Tara Hickey Simms

  • Pharmacist
  • Lafayette, LA
National Provider Identifier
1801408380
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
016313 Issued in LA
Practice address
4406 Johnston St
Lafayette, LA 70503-4234
Phone
(337) 984-5220
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 016313 LA Primary

Addresses

Primary practice location

4406 Johnston St
Lafayette, LA 70503-4234

Mailing address

4406 Johnston St
Lafayette, LA 70503-4234
Phone (337) 984-5220

Other names 1

  • Miss Tara Dee Hickey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
016313LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana CVS Pharmacy LLC PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1801408380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 JOHNSTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034234",
            "telephone_number": "337-984-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 JOHNSTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034234",
            "telephone_number": "337-984-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "TARA",
        "middle_name": "HICKEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "016313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HICKEY",
            "middle_name": "DEE",
            "prefix": "MISS",
            "credential": "RPH.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.