Healthcare Provider Details

I. General information

NPI: 1962763359
Provider Name (Legal Business Name): ANN ADAIR CODY SIMONES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN ADAIR CODY

II. Dates (important events)

Enumeration Date: 06/03/2012
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 EAST SECOND STREET
DULUTH MN
55805-1951
US

IV. Provider business mailing address

9117 TERRA VERDE TRL
EDEN PRAIRIE MN
55347-5256
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-8762
  • Fax:
Mailing address:
  • Phone: 952-270-6227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number59261
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number59261
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: