Individual provider Active NPI

Simone King Paul, ARNP-BC, WCC

  • Family Nurse Practitioner
  • Rockledge, FL
National Provider Identifier
1972054864
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9232062 Issued in FL
Practice address
4154 San Ysidro Way
Rockledge, FL 32955-5336
Phone
(321) 241-6244
Fax
(833) 301-0862
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 ARNP 9232062 FL Primary

Addresses

Primary practice location

4154 San Ysidro Way
Rockledge, FL 32955-5336

Mailing address

4154 San Ysidro Way
Rockledge, FL 32955-5336
Phone (321) 241-6244

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
I20170512000789 FL Practitioner - Nurse Practitioner 2264719632 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HC Florida PA 9 clinicians

Practice addresses (Care Compare)

1700 Monroe Ave
Maitland, FL 32751-6672
Phone (407) 647-2092

4154 San Ysidro Way
Rockledge, FL 32955-5336
Phone (321) 241-6244

Hospital & facility affiliations

  • Advanced Nursing Concepts LLC Home health agency, Orlando, FL, CCN 108314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9232062FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jose a Rivera LLC CurrentSince Dec 1, 2024 Accepting new patients
Bsa LLC CurrentSince Mar 8, 2017 Accepting new patients
Glomar Medical Inc. CurrentSince Mar 1, 2024 Accepting new patients
Brevard Wound Care Center, LLC CurrentSince Apr 1, 2021 Accepting new patients
Partners in Community Care, LLC CurrentSince Feb 1, 2020 Accepting new patients
Hickory Care LLC CurrentSince Jun 14, 2024 Accepting new patients

Locations

100 W Citrus St
Altamonte Springs, FL 32714
Phone (407) 720-4253

1700 Monroe Ave
Maitland, FL 32751
Phone (407) 647-2092

1140 Broadband Dr
Melbourne, FL 32901
Phone (321) 312-4178

7365 Orchestra Ln
Melbourne, FL 32940
Phone (321) 253-7450

445 Pineda Ct
Melbourne, FL 32940
Phone (321) 254-1611

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGIDCD
  • FHIR API: https://api.platform.athenahealth.com/23115/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1972054864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4154 SAN YSIDRO WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555336",
            "telephone_number": "321-241-6244",
            "fax_number": "833-301-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 SAN YSIDRO WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555336",
            "telephone_number": "321-241-6244",
            "fax_number": "833-301-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING PAUL",
        "first_name": "SIMONE",
        "credential": "ARNP-BC, WCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9232062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.