Simple Medicaid Ride LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

SIMPLE MEDICAID RIDE LLC

Practice address

1145 Gray Wolf Cir
Pueblo, CO 81001-4902

Phone

(603) 285-8398

NPI assigned

Mar 21, 2023

Organization subpart

No

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

Authorized official

Name

Sisay Kidane

Title

Owner

Phone

(603) 285-8398

Specialties & licenses 1

Addresses

Other names 1

• SIMPLE MEDICAID RIDE Doing business as

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1811699028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 GRAY WOLF CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810014902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 GRAY WOLF CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810014902",
            "telephone_number": "603-285-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE MEDICAID RIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "KIDANE",
        "authorized_official_first_name": "SISAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-285-8398"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIMPLE MEDICAID RIDE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Gordon Silver, MD
• Dyna A Simmons, PT
• Robert W. Simmons, PA-C
• Matthew P. Simonich, MD
• James E Simony II, M.D.
• Simplified Telehealth LLC
• Amy Simpson
• Brooke Simpson, P.T., D.P.T.
• Filipinas Sagario Simpson, L.M.T
• Kenna Joyann Simpson, RN

• Non-emergency Medical Transport (VAN) in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Non-emergency Medical Transport (VAN) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.