1346823044 NPI number — KAITLYN SIMON

Table of content: KAITLYN SIMON (NPI 1346823044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346823044 NPI number — KAITLYN SIMON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMON
Provider First Name:
KAITLYN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346823044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8665 WATERLYNN CIR NW APT 308
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28027-0034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-588-1660
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9025 NOVANT HEALTH PY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28215-0098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-785-1113
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: 1-23-69711 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G145119 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com