Stacey Robin Sims, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

007717-1 Issued in NY

Practice address

10832B Utah St
Fort Drum, NY 13603-3108

Phone

(321) 403-9457

NPI assigned

May 16, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1053671685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10832B UTAH ST",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136033108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10832B UTAH ST",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136033108",
            "telephone_number": "321-403-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "STACEY",
        "middle_name": "ROBIN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "007717-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "007717-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Shepherd, MS, RD/LD
• Krishna Shrestha, PA
• Kimberlyn Joy Sickler, RDH
• Robert B. Simmonds, PH.D.
• Brady Simpkins, PA-C
• Taylor Nichole Singer, PHD
• Neil Harry Sitenga Jr., M.D.
• Cale Ronald Siver
• Julia M Slepko, AT, LAT, ATC
• Matthew Sliwinski

• Occupational Therapy Assistant in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.