Provider Demographics
NPI:1396780367
Name:SIMONS, RHONDA KAYE (DO)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAYE
Last Name:SIMONS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:KAYE
Other - Last Name:CERMAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4240 BLUE RIDGE BLVD
Mailing Address - Street 2:SUITE 611
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-1713
Mailing Address - Country:US
Mailing Address - Phone:816-313-1711
Mailing Address - Fax:816-743-9442
Practice Address - Street 1:4240 BLUE RIDGE BLVD
Practice Address - Street 2:SUITE 611
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1713
Practice Address - Country:US
Practice Address - Phone:816-313-1711
Practice Address - Fax:816-743-9442
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO390200000X
MO2009006695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program