Individual provider Active NPI

Nixon Simon, APRN

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1972039592
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002074 Issued in FL
Practice address
1514 1St St N
Winter Haven, FL 33881-2476
Phone
(866) 234-8534
NPI assigned
May 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002074 FL Primary

Addresses

Primary practice location

1514 1St St N
Winter Haven, FL 33881-2476

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (866) 234-8534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002124 FL Practitioner - Nurse Practitioner 0345643052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Health Care IncGroup PAC ID 0143127951, 33 clinicians

Practice addresses (Care Compare)

1514 1St St N
Winter Haven Clinic
Winter Haven, FL 33881-2476
Phone (866) 234-8534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11002074FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc CurrentSince Aug 10, 2022 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Central Florida Health Care, Inc. CurrentSince Aug 10, 2022 Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

1514 1st St N
Winter Haven, FL 33881
Phone (863) 291-5110

47 5th St NW
Winter Haven, FL 33881

Interoperability endpoints

  • Direct secure messaging: nixon.simon.1@12125.direct.athenahealth.com

Organizations & group practices 12

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1972039592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "866-234-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812476",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "NIXON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.