Individual provider Active NPI

William Cody Simmons

  • Physical Therapy Assistant
  • Jackson, MS
National Provider Identifier
1821638933
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-4328 Issued in MS
Practice address
5140 Galaxie Dr
Jackson, MS 39206-4335
Phone
(769) 216-3288
NPI assigned
Jan 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-4328 MS Primary

Addresses

Primary practice location

5140 Galaxie Dr
Jackson, MS 39206-4335

Mailing address

5140 Galaxie Dr
Jackson, MS 39206-4335
Phone (769) 216-3288

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
PTA-4328MSMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inmotion Rehab LLC Physical Therapy Assistant CurrentSince Jan 12, 2020 Accepting new patients

Locations

5140 Galaxie Dr
Jackson, MS 39206
Phone (769) 216-3288

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1821638933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 GALAXIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064335",
            "telephone_number": "769-216-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 GALAXIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064335",
            "telephone_number": "769-216-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "WILLIAM",
        "middle_name": "CODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA-4328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.