Individual provider Active NPI

Brian E Sims, D.O.

  • Pediatrics Physician
  • Waterloo, IA
National Provider Identifier
1023051554
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
03293 Issued in IA
Practice address
2710 Saint Francis Dr
Suite 510
Waterloo, IA 50702-5619
Phone
(319) 272-5000
Fax
(319) 272-5445
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 03293 IA Primary

Addresses

Primary practice location

2710 Saint Francis Dr
Suite 510
Waterloo, IA 50702-5619

Mailing address

2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590

Other identifiers 1

IdentifierTypeStateIssuer
0208926MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000893 IA Practitioner - Pediatric Medicine 2163554528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

226 Bluebell Rd
Cedar Falls, IA 50613-6328
Phone (319) 575-5800

2710 Saint Francis Dr
Waterloo, IA 50702-5619
Phone (319) 272-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
03293IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. CurrentSince Jun 1, 2010 Accepting new patients
Covenant Medical Center Inc CurrentSince Jun 1, 2010 Accepting new patients
Boone County Hospital Past Accepting new patients
Covenant Medical Center Inc Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

226 Bluebell Rd
Cedar Falls, IA 50613
Phone (319) 575-5800

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

2710 Saint Francis Dr
Ste 510
Waterloo, IA 50702

2101 Kimball Ave
#14
Waterloo, IA 50702

Interoperability endpoints

  • Direct secure messaging: bsims3936645@direct.trinity-health.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1023051554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "SUITE 510",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "03293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208926",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.