QUANIKA SHUNTAAYE SIMPSON-JACKSON (NPI# 1114400637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114400637 |
Entity Type | Individual |
Full Name | QUANIKA SHUNTAAYE SIMPSON-JACKSON |
Credential | MD |
Practice Address |
202 E Earll Dr Ste 360 Phoenix AZ 85012-2677 |
Mailing Address |
5060 N 19th Ave Ste 300-28 Phoenix AZ 85015-3210 |
Practice Telephone | 6026988261 |
Mailing Telephone | 6026988261 |
Enumeration Date | 2018-09-11 |
Last Update Date | 2020-07-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
51627-AO-0 | NV | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | 8389PCS0 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
2020 Pinto Ln, Las Vegas, NV 891064019 | 7024174702 | |
5060 N 19th Ave Ste 300-28, Phoenix, AZ 850153210 | 6026988261 |
Street Address |
202 E EARLL DR STE 360 |
City | PHOENIX |
State | AZ |
Zip Code | 85012-2677 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215285051 | Laura Elizabeth Fox | Physician Assistant | 202 E Earll Dr Ste 360, Phoenix, AZ 85012-2677 | 2012-08-28 |
1346840055 | Megan Marie Youngstead | Nurse Practitioner | 202 E Earll Dr Ste 360, Phoenix, AZ 85012-2677 | 2020-10-30 |
1134680820 | Reflection Health Services L.L.C. | Psychiatric Residential Treatment Facility | 202 E Earll Dr Ste 360, Phoenix, AZ 85012-2677 | 2019-03-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
Find all providers in zip 85012 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528679354 | Arizona Hospitalists, Pllc | Emergency Medicine | 10255 N 43rd St, Phoenix, AZ 85028-4108 | 2020-08-14 |
1477641991 | Lincoln Physician Billing, LLC | Emergency Medicine | 2500 W Utopia Rd Ste 100, Phoenix, AZ 85027-4172 | 2006-10-10 |
1255845517 | Kristina Yvonne Keilson | Emergency Medicine | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2017-11-24 |
1932466331 | Mark R Engelman | Emergency Medicine | 4400 N 32nd St, Ste #150, Phoenix, AZ 85018-3953 | 2012-04-23 |
1225311871 | Acute Care Surgical Specialists, LLC | Emergency Medicine | 9250 N 3rd St, Suite 3015, Phoenix, AZ 85020-2437 | 2011-09-20 |
1386935013 | Bryan Heidrich | Emergency Medicine | 2601 E Roosevelt St, Department of Emergency Medicine, Phoenix, AZ 85008-4973 | 2011-04-28 |
1073847695 | Christopher Quinn May | Emergency Medicine | 2601 E Roosevelt St, Department of Emergency Medicine, Phoenix, AZ 85008-4973 | 2009-09-29 |
1003065004 | Joel Philip Betz | Emergency Medicine | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2008-09-15 |
1982863429 | Ian James Thomas | Emergency Medicine | 9250 N 3rd St, Suite 3015, Phoenix, AZ 85020-2437 | 2008-06-09 |
1114120896 | Kevin R Johnson | Emergency Medicine | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2007-06-08 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.