Jack E Simons, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R5F87 Issued in MO

Practice address

2 Lochhaven LN
Manchester, MO 63021-8020

Phone

(314) 420-0104

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902020936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LOCHHAVEN LN",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630218020",
            "telephone_number": "314-420-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LOCHHAVEN LN",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630218020",
            "telephone_number": "314-420-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "JACK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R5F87",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Forth Sevier, L.P.C.
• Areen A Shahab, PHARMD
• Aya M Sherif
• Mariah Shores
• Vicki I Simmons, LPC
• Christine Renaud Sinks, P.T.
• Wendi Smith, P.T.
• Solace Hospice Care LLC
• Susan G. Solsten, MSW, LCSW
• Carissa Speelman, M.A. CCC-SLP

• Emergency Medicine Physician in Manchester, MO
• Providers in Manchester, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.