Active NPI
Ronald E Simmons, PAC
- Physician Assistant
- De Kalb Junction, NY
National Provider Identifier
1891859922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000499
- Practice address
- 2924 County Route 17
Dekalb Junction, NY 13630 - Phone
- (315) 347-3830
- Fax
- (315) 347-3840
- NPI assigned
- Dec 21, 2006
- Last updated
- Aug 1, 2013
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000499 | NY | Primary |
Addresses
Primary practice location
2924 County Route 17
Dekalb Junction, NY 13630
Mailing address
2924 County Route 17
Dekalb Junction, NY 13630
Phone (315) 347-3830
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1891859922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2924 COUNTY ROUTE 17",
"city": "DEKALB JUNCTION",
"state": "NY",
"postal_code": "13630",
"telephone_number": "315-347-3830",
"fax_number": "315-347-3840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2924 COUNTY ROUTE 17",
"city": "DEKALB JUNCTION",
"state": "NY",
"postal_code": "13630",
"telephone_number": "315-347-3830",
"fax_number": "315-347-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "RONALD",
"middle_name": "E",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "000499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Kalb Junction, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.