Bern Simo Mukam

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN1006539 Issued in DC

Practice address

1100 Alabama Ave SE
Washington, DC 20032-4542

Phone

(202) 299-5505

NPI assigned

Apr 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Elite Healthcares Inc

  • Developmental Disabilities Clinic/Center
  • Washington, DC
  • NPI 1073206298
  NPD

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1841811205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ALABAMA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324542",
            "telephone_number": "202-299-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ALABAMA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324542",
            "telephone_number": "202-299-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4407 Saddle River Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207203440",
            "country_code": "US",
            "telephone_number": "202-299-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMO MUKAM",
        "first_name": "BERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1006539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald Simms
• Susan Simms
• Teresa D Simms
• Wanda L. Simms
• Yvonne Simms
• Margaret Simon Dews
• Blanca Simon Frances, M.D.
• Bertina Paulette Simon-Odom
• Alan E Simon, M.D.
• Barry George Simon, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.