Individual provider Active NPI

Madeline Grace Simmons

  • Occupational Therapy Assistant
  • New Albany, IN
National Provider Identifier
1932835832
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
99112615A Issued in IN
Practice address
326 Country Club Dr
New Albany, IN 47150-4618
Phone
(812) 948-1311
NPI assigned
Jul 25, 2022
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 99112615A IN Primary

Addresses

Primary practice location

326 Country Club Dr
New Albany, IN 47150-4618

Mailing address

2201 Deercross Dr Unit 106
Louisville, KY 40220-6728

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

State licenses

LicenseStateTypeSpecialty
99112615AINMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1932835832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 DEERCROSS DR UNIT 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402206728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 COUNTRY CLUB DR",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504618",
            "telephone_number": "812-948-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MADELINE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "99112615A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.