TIMOTHY ROBERT SIMIC NURSE PRACTITIONER NPI 1053904896

NPI Information

NPI: 1053904896
Provider Name: TIMOTHY ROBERT SIMIC, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1357 BARDSTOWN RD
LOUISVILLE, KY
ZIP 40204
Phone: (502) 897-6443
Get Directions

Timothy Robert Simic, NURSE PRACTITIONER is a family nurse practitioner in Louisville, KY. Timothy Robert Simic, NURSE PRACTITIONER NPI is 1053904896. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1357 BARDSTOWN RD
LOUISVILLE, KY
ZIP 40204-353
Phone: (502) 897-6443

The enumeration date for this NPI number is 2/12/2021 and was last updated on 3/17/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WE0003X	Registered Nurse	Emergency	1102450	KENTUCKY	No
2	363LF0000X	Nurse Practitioner	Family	3015217	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100571750	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »