Individual provider Active NPI

Marjorie Ann Simon, LPN

  • Licensed Practical Nurse
  • East Wareham, MA
National Provider Identifier
1932894664
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN60952 Issued in MA
Practice address
3088 Cranberry Hwy Ste a
East Wareham, MA 02538-4800
Phone
(508) 295-7990
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN60952 MA Primary

Addresses

Primary practice location

3088 Cranberry Hwy Ste a
East Wareham, MA 02538-4800

Mailing address

3088 Cranberry Hwy Ste a
East Wareham, MA 02538-4800
Phone (508) 295-7990

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
LN60952MAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Habit Opco, LLC PastSince Apr 16, 2023 Accepting new patients
Habit Opco, LLC PastSince Apr 16, 2023 Accepting new patients

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1932894664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3088 CRANBERRY HWY STE A",
            "city": "EAST WAREHAM",
            "state": "MA",
            "postal_code": "025384800",
            "telephone_number": "508-295-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088 CRANBERRY HWY STE A",
            "city": "EAST WAREHAM",
            "state": "MA",
            "postal_code": "025384800",
            "telephone_number": "508-295-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MARJORIE",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN60952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.