Individual provider Active NPI

Eunice J Simon, APRN

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1912250952
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0812124 Issued in OK
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

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130719000709 OK Practitioner - Nurse Practitioner 1951542752 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
R0093051OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Simon Wellness LLC Family CurrentSince Aug 12, 2020 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

  • Direct secure messaging: simonwellness.eunicesimon@160387.advancedmd-direct.com
  • FHIR API: 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.

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

Verify at the official NPI Registry.