Organization Active NPI

Clifford W Sims MD PC

  • Ophthalmology Physician
  • Memphis, TN
National Provider Identifier
1205021227
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD10502 Issued in TN
Legal business name
CLIFFORD W SIMS MD PC
Practice address
1407 Union Ave Ste 1003
Memphis, TN 38104-3678
Phone
(901) 526-8393
Fax
(901) 526-8331
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Dr. Clifford W Sims Jr., MDNPI 1023170925
Title
President
Phone
(901) 526-8393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD10502 TN Primary

Addresses

Primary practice location

1407 Union Ave Ste 1003
Memphis, TN 38104-3678

Mailing address

1407 Union Ave Ste 1003
Memphis, TN 38104-3678
Phone (901) 526-8393

Other identifiers 1

IdentifierTypeStateIssuer
3163225MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120111000423 TN Part B Supplier - Clinic/Group Practice 0749457968 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

920 Madison Ave
Ste 901
Memphis, TN 38103
Phone (901) 526-8393

1407 Union Ave
Ste 1003
Memphis, TN 38104
Phone (901) 526-8393

910 Madison Ave
Ste 906
Memphis, TN 38103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1205021227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE STE 1003",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043678",
            "telephone_number": "901-526-8393",
            "fax_number": "901-526-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE STE 1003",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043678",
            "telephone_number": "901-526-8393",
            "fax_number": "901-526-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD W SIMS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-526-8393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD10502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3163225",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.