Individual provider Active NPI

John Sims

  • Community Health Worker
  • Palmer, AK
National Provider Identifier
1154916831
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
4001 N Westlake Ave
Palmer, AK 99645-8864
Phone
(907) 414-0408
NPI assigned
Mar 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

4001 N Westlake Ave
Palmer, AK 99645-8864

Mailing address

1365 E Parks Hwy Ste 101
Wasilla, AK 99654-8297
Phone (907) 357-6445

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

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1154916831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 E PARKS HWY STE 101",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548297",
            "telephone_number": "907-357-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 N WESTLAKE AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458864",
            "telephone_number": "907-414-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.