Basic Information
| Provider Information | |||||||||
| NPI: | 1396780367 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMONS | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | KAYE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CERMAK | ||||||||
| OtherFirstName: | RHONDA | ||||||||
| OtherMiddleName: | KAYE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4240 BLUE RIDGE BLVD | ||||||||
| Address2: | SUITE 611 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641331713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163131711 | ||||||||
| FaxNumber: | 8167439442 | ||||||||
| Practice Location | |||||||||
| Address1: | 4240 BLUE RIDGE BLVD | ||||||||
| Address2: | SUITE 611 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641331713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163131711 | ||||||||
| FaxNumber: | 8167439442 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 08/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 2009006695 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.