Miriam J Simon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055-0030096 Issued in VT

Practice address

NVRH Corner Medical
195 Industrial Pkwy
Lyndon, VT 05849

Phone

(802) 748-9501

NPI assigned

Jun 27, 2006

Last updated

Mar 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

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.

• Northern Counties Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • St Johnsbury, VT
  • NPI 1649236225
  Medicare reassignment NPD
• Northern Counties Health Care, Inc.

  dba Northern Express Care Newport

  • Federally Qualified Health Center (FQHC)
  • Newport, VT
  • NPI 1003564931
  NPD
• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  NPD (past)
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1881621753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405",
            "fax_number": "802-748-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NVRH CORNER MEDICAL",
            "address_2": "195 INDUSTRIAL PKWY",
            "city": "LYNDON",
            "state": "VT",
            "postal_code": "05849",
            "telephone_number": "802-748-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MIRIAM",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0030096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3075309",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002900",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brigitte France Dargis, MD
• Joyce M Dobbertin, M.D.,D.C.
• Susan P Erisman, M.D.
• Ashley K Gerrish, NP
• Susan L Gresser, M.D.
• Lloyd L Thompson III, M.D.

• Physician Assistant in Lyndon, VT
• Providers in Lyndon, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.