Active NPI
Eunice J Simon, APRN
- Family Nurse Practitioner
- Oklahoma City, OK
National Provider Identifier
1912250952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F0812124
- Practice address
- 1025 Straka Ter
Oklahoma City, OK 73139-2544 - Phone
- (405) 632-6688
- Fax
- (405) 604-0738
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0812124 | OK | Primary |
| Family Nurse Practitioner | 363LF0000X | R0093051 | OK |
Addresses
Primary practice location
1025 Straka Ter
Oklahoma City, OK 73139-2544
Mailing address
1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone (405) 632-6688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
Oklahoma City, OK 73142
Phone (405) 456-0101
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0093051 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simon Wellness LLC | Family | Current | Accepting new patients |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
1201 W Gore Blvd
Ste A
Lawton, OK 73501
Phone (580) 353-6776
4801 Gaillardia Pkwy
Ste 200
Oklahoma City, OK 73142
Phone (405) 456-0101
4801 Gaillardia Pkwy
Ste 224
Oklahoma City, OK 73142
Interoperability endpoints
- simonwellness.eunicesimon@160387.advancedmd-direct.com
- https://api.platform.athenahealth.com/22383/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Family Nurse Practitioner
- Oklahoma City, OK
- NPI 1225656549
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594684800000",
"number": "1912250952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 STRAKA TER",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731392544",
"telephone_number": "405-632-6688",
"fax_number": "405-604-0738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 STRAKA TER",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731392544",
"telephone_number": "405-632-6688",
"fax_number": "405-604-0738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "EUNICE",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-15",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "F0812124",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0093051",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.
- 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.