Provider Demographics
NPI:1619711447
Name:SIMMET, MEGAN FAYE (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:FAYE
Last Name:SIMMET
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-4123
Mailing Address - Country:US
Mailing Address - Phone:765-622-5330
Mailing Address - Fax:
Practice Address - Street 1:2457 GUM BRANCH RD STE 600700
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4008
Practice Address - Country:US
Practice Address - Phone:910-938-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015582A225100000X
NDCP031949T225100000X
MI5501303289225100000X
NCCP038593T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist