Active NPI
Craig Simon, LPN
- Licensed Practical Nurse
- Pocomoke City, MD
National Provider Identifier
1811535388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 0002076818
- Practice address
- 1532 Ocean Hwy Ste 102
Pocomoke City, MD 21851-3023 - Phone
- (443) 437-7128
- NPI assigned
- Dec 16, 2019
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0002076818 | VA | Primary |
Addresses
Primary practice location
1532 Ocean Hwy Ste 102
Pocomoke City, MD 21851-3023
Mailing address
2243 Pike Dr
Greenbackville, VA 23356-2670
Phone (443) 735-6705
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0002076818 | VA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1811535388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2243 PIKE DR",
"city": "GREENBACKVILLE",
"state": "VA",
"postal_code": "233562670",
"telephone_number": "443-735-6705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1532 OCEAN HWY STE 102",
"city": "POCOMOKE CITY",
"state": "MD",
"postal_code": "218513023",
"telephone_number": "443-437-7128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "CRAIG",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "VA",
"license": "0002076818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocomoke City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.