Active NPI
Raymond Lee Simmons, DDS
- Dentist
- Moorhead, MN
National Provider Identifier
1922044072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7603
- Practice address
- 523 8TH St S
Moorhead, MN 56560-3503 - Phone
- (218) 236-9319
- Fax
- (218) 236-9319
- NPI assigned
- Jun 20, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7603 | MN | Primary |
Addresses
Primary practice location
523 8TH St S
Moorhead, MN 56560-3503
Mailing address
523 8TH St S
Moorhead, MN 56560-3503
Phone (218) 236-9319
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61376SI | Other | MN | BLUE CROSS FEP |
| 989045 | Other | ND | DSCND |
| 40617 | Other | ND | ND MEDICAL ASSISTANCE |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922044072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 8TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565603503",
"telephone_number": "218-236-9319",
"fax_number": "218-236-9319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 8TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565603503",
"telephone_number": "218-236-9319",
"fax_number": "218-236-9319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "RAYMOND",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "7603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS FEP",
"identifier": "61376SI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSCND",
"identifier": "989045",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND MEDICAL ASSISTANCE",
"identifier": "40617",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- 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.