Individual provider Active NPI

Robert A Simonson, D.C.

  • Chiropractor
  • Fair Oaks, CA
National Provider Identifier
1891817490
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15390 Issued in CA
Practice address
8146 Greenback LN Ste 108
Fair Oaks, CA 95628-2539
Phone
(916) 723-3088
Fax
(916) 726-1507
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15390 CA Primary

Addresses

Primary practice location

8146 Greenback LN Ste 108
Fair Oaks, CA 95628-2539

Mailing address

8146 Greenback LN Ste 108
Fair Oaks, CA 95628-2539
Phone (916) 723-3088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120611000682 CA Practitioner - Chiropractic 5496919078 Practice locations: Fair Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8146 Greenback LN
Suite 108
Fair Oaks, CA 95628-2539
Phone (916) 723-3088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1891817490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8146 GREENBACK LN STE 108",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282539",
            "telephone_number": "916-723-3088",
            "fax_number": "916-726-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8146 GREENBACK LN STE 108",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282539",
            "telephone_number": "916-723-3088",
            "fax_number": "916-726-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.