Richard D Simon Jr., MD

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

MD00018852 Issued in WA

Practice address

401 W Poplar
Walla Walla, WA 99362

Phone

(509) 522-5946

Fax

(509) 522-5744

NPI assigned

Jul 28, 2006

Last updated

Mar 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services - Washington

  dba Poplar Medical Complex DME

  • Durable Medical Equipment & Medical Supplies
  • Walla Walla, WA
  • NPI 1174814552
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1942214333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1477",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620312",
            "telephone_number": "509-522-5815",
            "fax_number": "509-522-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-522-5946",
            "fax_number": "509-522-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00018852",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD00018852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8483406",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsimon185976@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 W Poplar",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "99362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shopko Stores Operating Co. LLC (ShopKo Optical 089)
• Shawn Michael Shugars, PT
• Karan Lea Shultz, MSW
• David N Silva, MSW, LICSW,BCD,CDP
• Neildra Ann Simmons, MSW
• Jennifer Simpson
• Rich D Simpson, MSW; DMHP
• Maranatha Sims, AU.D.
• Candy Sinden, RN
• Dana T Sineath, FNP-C

• Sleep Medicine (Internal Medicine) Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Sleep Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.