Karessa Mae Sims
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Colstrip, MT
NPI 1033930359 · NPPES record last updated Oct 19, 2024
Key facts
- NPI
- 1033930359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- NUR-APRN-LIC-243612 (MT)
- Practice address
- PO Box 2254
Colstrip, MT 59323-2254 - Phone
- (406) 529-1024
- NPI assigned
- Oct 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Colstrip, MT 59323
Phone (406) 529-1024
PO Box
Suite 2254
Colstrip, MT 59323
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260409001879 | MT | Practitioner - Nurse Practitioner | 3678048493 | Practice locations: Colstrip, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NUR-RN-LIC-48574 | MT | MD | Registered Nurse |
| NUR-APRN-LIC-243612 | MT | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | NUR-RN-LIC-48574 | MT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NUR-APRN-LIC-243612 | MT | Yes |
Addresses
Primary practice location
PO Box 2254
Colstrip, MT 59323-2254
Mailing address
PO Box 2254
Colstrip, MT 59323-2254
Other names
- Karessa Mae Dudley
NPI Registry JSON
{
"created_epoch": "1729296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729296000000",
"number": "1033930359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2254",
"city": "COLSTRIP",
"state": "MT",
"postal_code": "593232254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 2254",
"city": "COLSTRIP",
"state": "MT",
"postal_code": "593232254",
"telephone_number": "406-529-1024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMS",
"first_name": "KARESSA",
"middle_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-19",
"last_updated": "2024-10-19",
"certification_date": "2024-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MT",
"license": "NUR-RN-LIC-48574",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MT",
"license": "NUR-APRN-LIC-243612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KARESSA",
"last_name": "DUDLEY",
"middle_name": "MAE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colstrip, MT
- Montana RX Solutions, PLLC
- Michael Morlock
- Jose F Ortiz
- Jane Marie Pierce-McPherson
- Elizabeth Anne Reid
- Bridgette A Spang
- Transitions PC
All providers in Colstrip, MT · Psychiatric/Mental Health Nurse Practitioner in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.