Charles W. Simmons Jr., M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G71866 Issued in CA

Practice address

4077 5TH Ave
Emergency Medicine
San Diego, CA 92103-2105

Phone

(619) 260-7095

NPI assigned

Feb 9, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csimmons28117@scrippshlth.medalliesdirect.net

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.

• Pacific Emergency Providers, a Prof. Corp.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1497790539
  Medicare reassignment NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Clinic Medical Group, Inc

  • Radiation Oncology Physician
  • San Diego, CA
  • NPI 1073853180
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1801869839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 5TH AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 5TH AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CHARLES",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G71866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G718660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simmons Chiropractic, Inc.
• Alanna Inka Simmons
• Brett Patrick Simmons, MD
• Brighid Hayes Simmons, D.O.
• Chanda Gail Simmons, BACHELOR DEGREE
• Courtney Alexandra Simmons
• Doris Simmons, REGISTERED NURSE
• Dylan Simmons
• Goldy Simmons
• Jasmine Nicole Simmons

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.

Verify at the official NPI Registry.