Active NPI
Randy Pon Sim, PHARMD
- Pharmacist
- El Paso, TX
National Provider Identifier
1083387419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66206
- Practice address
- 5630 N Desert Blvd
El Paso, TX 79912-1636 - Phone
- (915) 845-1422
- NPI assigned
- Jul 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 66206 | TX | Primary |
Addresses
Primary practice location
5630 N Desert Blvd
El Paso, TX 79912-1636
Mailing address
5630 N Desert Blvd
El Paso, TX 79912-1636
Phone (915) 845-1422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66206 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients | |
| Albertsons LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- El Paso, TX
- NPI 1649217100
-
- Community/Retail Pharmacy
- Ardmore, OK
- NPI 1134958457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1083387419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5630 N DESERT BLVD",
"city": "EL PASO",
"state": "TX",
"postal_code": "799121636",
"telephone_number": "915-845-1422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5630 N DESERT BLVD",
"city": "EL PASO",
"state": "TX",
"postal_code": "799121636",
"telephone_number": "915-845-1422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIM",
"first_name": "RANDY",
"middle_name": "PON",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "66206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.