Active NPI
Simeon Wesley Ashworth, DO
- Emergency Medicine Physician
- Tacoma, WA
National Provider Identifier
1861462368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OP00002255
- Practice address
- Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-3004 - Phone
- (253) 968-3885
- NPI assigned
- Jan 25, 2006
- Reactivated
- Mar 14, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | OP00002255 | WA | Primary |
Addresses
Primary practice location
Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-3004
Mailing address
11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 985-1711
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0226246 | Other | WA | LIWA |
| 0226247 | Other | WA | LIWA |
| 0226248 | Other | WA | LIWA |
| 5517AS | Other | WA | BSWA |
| 8497836 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1861462368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11315 BRIDGEPORT WAY SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993004",
"telephone_number": "253-985-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984313004",
"telephone_number": "253-968-3885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHWORTH",
"first_name": "SIMEON",
"middle_name": "WESLEY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"deactivation_date": "2019-02-08",
"reactivation_date": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "OP00002255",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0226246",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0226247",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0226248",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "5517AS",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8497836",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.