SAMUEL SIMMONS PA-C NPI 1619305828

NPI Information

  • NPI: 1619305828
  • Provider Name: SAMUEL SIMMONS, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1280 E CALVADA BLVD
    PAHRUMP, NV
    ZIP 89048
  • Phone: (775) 751-3377

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NPI Details

Samuel Simmons, PA-C is a medical physician assistant in Pahrump, NV with 14 years of experience. Samuel Simmons, PA-C NPI is 1619305828. 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:

1280 E CALVADA BLVD
PAHRUMP, NV
ZIP 89048-693
Phone: (775) 751-3377
Fax: (775) 751-2323

The NPI 1619305828 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/25/2013 and was last updated on 10/30/2025.

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
1363AM0700XPhysician AssistantMedicalPA1690NEVADAYes
2363A00000XPhysician Assistant200272ALASKANo
3363A00000XPhysician AssistantPA-1085IDAHONo

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
11736158MEDICAIDALASKA
21619305828MEDICAIDNEVADA

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: 11/21/2025

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