Active NPI
Simira Louise Wilson, LCSW
- Clinical Social Worker
- Bridgewater, NJ
National Provider Identifier
1992031223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05401300
- Practice address
- 500 N Bridge St
Bridgewater, NJ 08807-2135 - Phone
- (908) 725-2800
- Fax
- (908) 704-1790
- NPI assigned
- Oct 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05401300 | NJ | Primary |
Addresses
Primary practice location
500 N Bridge St
Bridgewater, NJ 08807-2135
Mailing address
500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 527486 | Other | NJ | AGENCY MEDICARE PROVIDER NUMBER (PTAN) |
| 0023701 | Other | NJ | AGENCY MEDICAID PROVIDE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05401300 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256083200000",
"number": "1992031223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N BRIDGE ST",
"city": "BRIDGEWATER",
"state": "NJ",
"postal_code": "088072135",
"telephone_number": "908-725-2800",
"fax_number": "908-704-1790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N BRIDGE ST",
"city": "BRIDGEWATER",
"state": "NJ",
"postal_code": "088072135",
"telephone_number": "908-725-2800",
"fax_number": "908-704-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SIMIRA",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-21",
"last_updated": "2009-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05401300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY MEDICARE PROVIDER NUMBER (PTAN)",
"identifier": "527486",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY MEDICAID PROVIDE NUMBER",
"identifier": "0023701",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgewater, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.