Basic Information
Provider Information
NPI: 1790993244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMPSON
FirstName: BARBARA
MiddleName: ELLEN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 856 J CLYDE MORRIS BLVD
Address2: STE A
City: NEWPORT NEWS
State: VA
PostalCode: 236011318
CountryCode: US
TelephoneNumber: 7575944006
FaxNumber: 7575345190
Practice Location
Address1: 10510 JEFFERSON AVE
Address2: SIUTE D
City: NEWPORT NEWS
State: VA
PostalCode: 236013102
CountryCode: US
TelephoneNumber: 7575944720
FaxNumber: 7575944735
Other Information
ProviderEnumerationDate: 05/18/2007
LastUpdateDate: 09/27/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000X0101247476VAY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics

ID Information
IDTypeStateIssuerDescription
179099324405VA MEDICAID


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