Individual provider Active NPI

Vanessa C Sims, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1194057653
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN0000014728 Issued in TN
Practice address
1009 Lark St
Suite 2
Johnson City, TN 37604-8217
Phone
(423) 283-0776
Fax
(423) 283-0549
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN0000014728 TN Primary

Addresses

Primary practice location

1009 Lark St
Suite 2
Johnson City, TN 37604-8217

Mailing address

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other practice location 1

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 310-1000

Other practice location 2

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other identifiers 1

IdentifierTypeStateIssuer
1518074MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000680 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012046725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
14728TNMDNeurology Physical Therapist
APN0000014728TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jul 22, 2022 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2022 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

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.

Hospital & facility affiliations 3

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1194057653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 LARK ST",
            "address_2": "SUITE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048217",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042277",
            "country_code": "US",
            "telephone_number": "423-310-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMS",
        "first_name": "VANESSA",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000014728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518074",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.