Individual provider Active NPI

Sydney Simon, PHARMD

  • Pharmacist
  • Cody, WY
National Provider Identifier
1922586593
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4090 Issued in WY
Practice address
1585 Sheridan Ave
Cody, WY 82414-3819
Phone
(307) 587-2017
NPI assigned
Aug 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60867119 WA
Pharmacist 183500000X 4090 WY Primary

Addresses

Primary practice location

1585 Sheridan Ave
Cody, WY 82414-3819

Mailing address

3 Oak Dr
Cody, WY 82414-8200
Phone (303) 818-9156

Other practice location 1

412 E College Way
Mount Vernon, WA 98273-5516
Phone (360) 424-7958

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH60867119WAMDPharmacist
4090WYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Apr 17, 2022 Accepting new patients
Walgreen Co PastSince May 16, 2021 Accepting new patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Locations

1585 Sheridan Ave
Cody, WY 82414
Phone (307) 587-2017

Organizations & group practices 4

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": "1533427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1922586593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 OAK DR",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148200",
            "telephone_number": "303-818-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143819",
            "telephone_number": "307-587-2017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E College Way",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982735516",
            "country_code": "US",
            "telephone_number": "360-424-7958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SYDNEY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-05",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60867119",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "4090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.