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1174917082 NPI number — RAEANNA POPLUS SIMCOE MD

NPI Number: 1174917082
Health Care Provider/Practitioner: RAEANNA POPLUS SIMCOE MD

Information about “1174917082” NPI (RAEANNA POPLUS SIMCOE MD) exists in 1174917082 in HTML format HTML  |  1174917082 in plain Text format TXT  |  1174917082 in PDF (Portable Document Format) PDF  |  1174917082 in an XML format XML  formats.

NPI Number : 1174917082 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174917082",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SIMCOE",
    "FirstName": "RAEANNA",
    "MiddleName": "POPLUS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "POPLUS",
    "OtherFirstName": "RAEANNA",
    "OtherMiddleName": "LEE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 388",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FISHERSVILLE",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22939-0388",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "540-332-5168",
    "MailingAddressFaxNumber": "540-332-5875",
    "FirstLinePracticeLocationAddress": "201 LEW DEWITT BLVD STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WAYNESBORO",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22980-1663",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "540-245-7940",
    "PracticeLocationAddressFaxNumber": "540-245-7941",
    "EnumerationDate": "03/28/2015",
    "LastUpdateDate": "05/06/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "0101274465",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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