Active NPI
Kyle Edwin Simmers, M.D.
- Pediatrics Physician
- Niceville, FL
National Provider Identifier
1891770723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME86100
- Practice address
- 2001 E Highway 20
Pediatric Department
Niceville, FL 32578-8826 - Phone
- (850) 897-4400
- Fax
- (850) 897-0623
- NPI assigned
- Dec 14, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME86100 | FL | Primary |
Addresses
Primary practice location
2001 E Highway 20
Pediatric Department
Niceville, FL 32578-8826
Mailing address
2001 E. Highway 20
Pediatric Department
Niceville, FL 32578
Phone (850) 897-4400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48088 | Other | FL | BCBSFL |
| 270268100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- kyle.simmers.1@21123.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Clinic/Center
- Fort Walton Beach, FL
- NPI 1225981707
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": "1485129600000",
"number": "1891770723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 E. HIGHWAY 20",
"address_2": "PEDIATRIC DEPARTMENT",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "32578",
"telephone_number": "850-897-4400",
"fax_number": "850-897-0623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 E HIGHWAY 20",
"address_2": "PEDIATRIC DEPARTMENT",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325788826",
"telephone_number": "850-897-4400",
"fax_number": "850-897-0623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMERS",
"first_name": "KYLE",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME86100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSFL",
"identifier": "48088",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270268100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.