Individual provider Active NPI

Lalitha Vadlamani-Simmers, M.D.

  • Pediatrics Physician
  • Niceville, FL
National Provider Identifier
1861477671
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME81854 Issued in FL
Practice address
490 Highway 85 N Ste a
Niceville, FL 32578-1010
Phone
(850) 419-2691
Fax
(850) 353-2142
NPI assigned
Dec 14, 2005
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME81854 FL Primary

Addresses

Primary practice location

490 Highway 85 N Ste a
Niceville, FL 32578-1010

Mailing address

1590 Ruckel Dr
Niceville, FL 32578-1603
Phone (850) 621-5058

Other identifiers 1

IdentifierTypeStateIssuer
262647100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beachside Pediatric Associates, P.a. CurrentSince Dec 1, 2020 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Women & Children First, LLC Past Accepting new patients
Privia Medical Group Florida, LLC Past Accepting new patients

Locations

842 State Highway 20 E
Ste 106
Freeport, FL 32439

490 Highway 85 N
Ste A
Niceville, FL 32578
Phone (850) 279-4600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22855/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lalitha.vadlamani-simmers.1@8042.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1861477671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 RUCKEL DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781603",
            "telephone_number": "850-621-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 85 N STE A",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781010",
            "telephone_number": "850-419-2691",
            "fax_number": "850-353-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADLAMANI-SIMMERS",
        "first_name": "LALITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME81854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262647100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

Verify at the official NPI Registry.