Providers
All 21 in TN
MATTHEW SIMMONS, M.A., LPC-MHSP
NPI 1003473992, individual, Nashville, TN, Counselor, Mental Health
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 15 months, but with up to 580 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 8669, $2.3M at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Sep 2022 | More hours than a day holds at a conservative unit price | 22.2 | 42.1 | 28.1 | 38.3 | 341 | 1 | 90791 90832 90834 90837 | $81K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 20.8 | 39.7 | 26.4 | 39.0 | 350 | 1 | 90791 90832 90834 90837 | $79K |
| Nov 2022 | More hours than a day holds at a conservative unit price | 19.6 | 37.6 | 25.1 | 34.2 | 346 | 1 | 90791 90832 90834 90837 | $71K |
| Dec 2022 | More hours than a day holds at a conservative unit price | 19.0 | 37.0 | 24.7 | 34.8 | 348 | 1 | 90791 90832 90834 90837 | $74K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 21.6 | 40.8 | 27.2 | 38.4 | 466 | 1 | 90791 90832 90834 90837 90847 | $83K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 18.6 | 36.1 | 24.1 | 33.7 | 389 | 1 | 90791 90832 90834 90837 | $66K |
| Jun 2023 | More hours than a day holds at a conservative unit price | 19.7 | 37.9 | 25.3 | 34.4 | 580 | 1 | 90791 90832 90834 90837 | $73K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 28.1 | 56.5 | 37.6 | 55.6 | 473 | 1 | 90791 90832 90834 90837 | $112K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 34.5 | 68.2 | 45.5 | 61.3 | 535 | 1 | 90791 90832 90834 90837 | $136K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 33.4 | 66.5 | 44.3 | 63.3 | 541 | 1 | 90791 90832 90834 90837 | $128K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 36.8 | 71.9 | 47.9 | 67.5 | 570 | 1 | 90791 90832 90834 90837 | $143K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 34.5 | 68.9 | 45.9 | 62.6 | 517 | 1 | 90791 90832 90834 90837 | $133K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 24.8 | 50.4 | 33.6 | 49.6 | 416 | 1 | 90791 90832 90834 90837 | $100K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 27.3 | 51.1 | 34.1 | 46.0 | 422 | 1 | 90791 90832 90834 90837 | $108K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 28.4 | 53.8 | 35.9 | 49.5 | 457 | 1 | 90791 90832 90834 90837 | $107K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MATTHEW SIMMONS, M.A., LPC-MHSP |
| Type | Individual |
| Status | Active |
| NPI issued | May 25, 2019, last updated May 25, 2019 |
| Practice location | 2400 WHITE AVE, Nashville, TN 37204-2235, 615-460-4200 |
| Specialties | Counselor, Mental Health (101YM0800X, primary, license 3126 TN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $868K | 36% | $245 | $191 (top 5% from $442) | 71st percentile | |
| 90834 | Psychotherapy, 45 minutes | $604K | 25% | $159 | $101 (top 5% from $318) | 75th percentile | |
| 90832 | Psychotherapy, 30 minutes | $502K | 21% | $125 | $59 (top 5% from $239) | 86th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $420K | 18% | $205 | $105 (top 5% from $228) | 93rd percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $4K | 0% | $131 | $130 (top 5% from $458) | too few months to rank |
In this area
21 providers in Davidson County, TN carry an indicator in the public record, with $23.9M at stake between them. The most common is more hours than a day holds, on 17 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | XUHAN ZHANG Nashville, TN, ranked 878 | $4K |
|
| 3 | NASHVILLE SNF HEALTHCARE LLC Nashville, TN, ranked 2899 | $0 |
|
| 3 | GOODLETTSVILLE SNF HEALTHCARE LLC Goodlettsville, TN, ranked 3431 | $0 |
|
| 3 | ANTIOCH TN OPCO, LLC Antioch, TN, ranked 5529 | $0 |
|
| 3 | HEART AND SOUL HOSPICE LLC Nashville, TN, ranked 7130 | $0 |
|
| 4 | ANNA TUKIVAKALA-HOLLY Nashville, TN, ranked 7619 | $2.5M |
|
| 4 | RICHARD CURRAN Nashville, TN, ranked 8247 | $357K |
|
| 4 | ROBERT YOUNG Madison, TN, ranked 8358 | $6.4M |
|
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 10, 2026
Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances
The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.
DOJSentencedJul 8, 2026
Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud
Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.
DOJSentencedJun 24, 2026
Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud
The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.
DOJChargedJun 23, 2026
Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme
Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.
DOJIndictedJun 23, 2026
Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges
Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.