AMANDA RENAE SIMMONS (NPI# 1629683230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629683230 |
Entity Type | Individual |
Full Name | AMANDA RENAE SIMMONS |
Credential | PA-C |
Practice Address |
1541 Kings Hwy Shreveport LA 71103-4228 |
Mailing Address |
318 Ace St Haughton LA 71037-8774 |
Practice Telephone | 3186260000 |
Mailing Telephone | 3184230251 |
Enumeration Date | 2020-09-10 |
Last Update Date | 2020-09-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
324297 | LA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | PHYSICIAN ASSISTANT LICENSURE | 324297 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164070975 | Amanda R Simmons | Behavior Technician | 2185 Normandie Dr, Montgomery, AL 36111-2728 | 2019-08-27 |
1386129096 | Amanda Simmons | Occupational Therapist | 1920 Thoreau Dr N Ste 180, Schaumburg, IL 60173-4151 | 2018-09-27 |
1396234043 | Amanda Dimasi Simmons | Nurse Practitioner | 101 Sivley Rd Sw, Huntsville, AL 35801-4421 | 2018-05-08 |
1912448648 | Amanda Simmons | Occupational Therapist | 405 8th St Ne, Washington, DC 20002-5227 | 2017-03-14 |
1033577374 | Amanda Simmons | Specialist | 3890 Jenks Ave, Lynn Haven, FL 32444-4701 | 2016-02-01 |
1407225675 | Amanda Rose Simmons | Counselor | 2450 S Vine St, Denver, CO 80210-5264 | 2015-09-17 |
1487047858 | Amanda Simmons | Acupuncturist | 366 Us Route 1, Falmouth, ME 04105-1371 | 2015-03-10 |
1235533019 | Amanda Simmons | Occupational Therapist | 5728 Moon Flower Ct, Fort Worth, TX 76244-5189 | 2014-10-22 |
1578987764 | Amanda Nicole Simmons | Psychologist | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2014-02-10 |
1700013315 | Amanda Corrine Simmons | Obstetrics & Gynecology | 10004 Kennerly Rd, Ste 395b, Saint Louis, MO 63128-2141 | 2009-06-22 |
Street Address |
1541 KINGS HWY |
City | SHREVEPORT |
State | LA |
Zip Code | 71103-4228 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912909912 | Brfhh Shreveport LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2005-08-10 |
1851991947 | Gina Marie Kristiansen | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-28 |
1376142893 | Candice Crow | Internal Medicine | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-26 |
1518574441 | Jadebrey Vyshette Kennon | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-24 |
1255945382 | Frank James List | Pharmacy Technician | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-05 |
1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
1740899400 | Brittany Allyson Bozzell | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-29 |
1386253169 | Kristyn Turner | Pharmacist | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-28 |
1508481722 | Alexandra Blair Lemaire | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-06-12 |
1508481953 | Amy Deneal Lewing | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-06-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
Find all providers in zip 71103 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
1831412626 | Christopher Micheal Magill | Physician Assistant | 2551 Greenwood Rd Ste 210, Shreveport, LA 71103-3985 | 2010-03-08 |
1851401426 | Teresa Bigler | Physician Assistant | 1606 Kings Hwy, Shreveport, LA 71103-4128 | 2006-08-30 |
1730118365 | Tina Faith Gentry | Physician Assistant | 7925 Youree Dr Suite 280b, Shreveport, LA 71105-5538 | 2006-07-03 |
1487616538 | David Stanley Staton | Physician Assistant | Overton Brooks Vamc, 510 East Stoner Ave, Shreveport, LA 71101 | 2006-04-04 |
1114924404 | Mary Mcferren | Physician Assistant | 1455 E Bert Kouns Industrial Loop # 200, Shreveport, LA 71105 | 2005-07-01 |
1487252029 | Melissa Raney | Physician Assistant | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2020-10-15 |
1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
1811459449 | Lyndsey Pate Day | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-04-02 |
1497139695 | Amanda Barnes | Physician Assistant | 7045 Youree Dr, Shreveport, LA 71105-5108 | 2015-07-17 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71103 |
Please comment or provide details below to improve the information on AMANDA RENAE SIMMONS.
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.