Individual provider Active NPI

Vanessa Brooke Sims, APRN

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1124431382
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004919A Issued in IN
Practice address
111 Quartermaster CT
Jeffersonville, IN 47130-3627
Phone
(812) 920-3005
Fax
(866) 554-1805
NPI assigned
Jun 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004919A IN Primary

Addresses

Primary practice location

111 Quartermaster CT
Jeffersonville, IN 47130-3627

Mailing address

111 Quartermaster CT
Jeffersonville, IN 47130-3627
Phone (812) 920-3005

Other identifiers 2

IdentifierTypeStateIssuer
201231570MedicaidIN
7100554480MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140709002238 IN Practitioner - Nurse Practitioner 3971728882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
VB Medical GroupGroup PAC ID 5193134666, 2 clinicians

Practice addresses (Care Compare)

111 Quartermaster CT
Jeffersonville, IN 47130-3627
Phone (812) 920-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71004919AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nora Urgent Care LLC CurrentSince Jul 1, 2018 Accepting new patients
VB Medical Group Family CurrentSince Dec 20, 2020 Accepting new patients
Nora Urgent Care LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

650 N Girls School Rd
#F40
Indianapolis, IN 46214
Phone (317) 299-4033

860 E 86th St
Ste 4
Indianapolis, IN 46240
Phone (317) 975-3441

111 Quartermaster Ct
Jeffersonvlle, IN 47130
Phone (812) 920-3005

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGDECD/Endpoint/BGDECD

Organizations & group practices 3

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1124431382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 QUARTERMASTER CT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303627",
            "telephone_number": "812-920-3005",
            "fax_number": "866-554-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 QUARTERMASTER CT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303627",
            "telephone_number": "812-920-3005",
            "fax_number": "866-554-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "VANESSA",
        "middle_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004919A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201231570",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100554480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.