Active NPI
Maria Simon
- Pharmacist
- Marysville, WA
National Provider Identifier
1861980948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60913015
- Practice address
- 16818 Twin Lakes Ave
Marysville, WA 98271-4724 - Phone
- (360) 386-4021
- NPI assigned
- Apr 25, 2018
- Last updated
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 76515 | CA | |
| Pharmacist | 183500000X | PH60913015 | WA | Primary |
Addresses
Primary practice location
16818 Twin Lakes Ave
Marysville, WA 98271-4724
Mailing address
603 S Lake Ave
Pasadena, CA 91106-3915
Phone (626) 844-5049
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
| License | State | Type | Specialty |
|---|---|---|---|
| 76515 | CA | MD | Pharmacist |
| PH60913015 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
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, 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": "1524614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1861980948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 S LAKE AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911063915",
"telephone_number": "626-844-5049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16818 TWIN LAKES AVE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982714724",
"telephone_number": "360-386-4021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "MARIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-25",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76515",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60913015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.