Individual provider Active NPI

Garrick R Simmons, M.D.

  • Urology Physician
  • Missoula, MT
National Provider Identifier
1912940693
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
9926 Issued in MT
Practice address
2875 Tina Ave, Suite 101
Missoula, MT 59808
Phone
(406) 728-3366
Fax
(406) 728-0651
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 9926 MT Primary

Addresses

Primary practice location

2875 Tina Ave, Suite 101
Missoula, MT 59808

Mailing address

2875 Tina Ave, Suite 101
Missoula, MT 59808
Phone (406) 728-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031215000898 MT Practitioner - Urology 8325945694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9921MTMDRegistered Nurse
9926MTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Valleys Urology Urology CurrentSince Jun 1, 2003 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2833 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 542-6559

2875 Tina Ave
Ste 101
Missoula, MT 59808
Phone (406) 728-3366

601 W Spruce St
Ste G
Missoula, MT 59802
Phone (406) 728-3366

Interoperability endpoints

  • Direct secure messaging: garrickin@fvu.emadirect.md

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1912940693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE, SUITE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59808",
            "telephone_number": "406-728-3366",
            "fax_number": "406-728-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE, SUITE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59808",
            "telephone_number": "406-728-3366",
            "fax_number": "406-728-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "GARRICK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.