Individual provider Active NPI

Teresa Marie Sims, FNP-BC

  • Family Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1124441571
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R867261 Issued in MS
Practice address
2207 5TH St N
Columbus, MS 39705-2211
Phone
(662) 251-3565
Fax
(662) 241-7176
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 R867261 MS Primary

Addresses

Primary practice location

2207 5TH St N
Columbus, MS 39705-2211

Mailing address

2207 5TH St N
Columbus, MS 39705-2211
Phone (662) 241-7177

Other identifiers 1

IdentifierTypeStateIssuer
03200051MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20140805001063 MS Practitioner - Nurse Practitioner 9133346711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2207 5TH St N
Columbus, MS 39705-2211
Phone (662) 241-7177

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient Care Medical Clinic LLC CurrentSince Aug 1, 2015 Accepting new patients

Locations

2207 5th St N
Columbus, MS 39705
Phone (662) 241-7177

Interoperability endpoints

  • Direct secure messaging: teresa.sims.1@11777.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11777/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1124441571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-241-7177",
            "fax_number": "662-241-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-251-3565",
            "fax_number": "662-241-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03200051",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.