Jequithia L Sims, NDTR

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

86170507 Issued in TX

Practice address

2952 Trail Lake Dr
Grand Prairie, TX 75054-5570

Phone

(214) 687-7203

NPI assigned

Mar 31, 2025

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

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1104629617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 TRAIL LAKE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750545570",
            "telephone_number": "214-687-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 TRAIL LAKE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750545570",
            "telephone_number": "214-687-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "JEQUITHIA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NDTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "TX",
            "license": "86170507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Simon
• Simon'S Heart P.C.
• Simple Dentist PLLC
• Monica Simpson, LPC
• Alyssa Sims, RN
• Michael D Sims, M.D.
• Terranie Sims
• Jaspreet Singh
• Sravani Singh, DMD
• Sireesha Janga MD PA

• Registered Dietetic Technician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Registered Dietetic Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.