Kormyn Shay Sims

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

100 Rivendell Dr
Benton, AR 72019-9188

Phone

(870) 572-5005

Fax

(870) 572-5000

NPI assigned

Aug 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1215216593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DRIVE",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72019",
            "telephone_number": "870-572-5005",
            "fax_number": "870-572-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199188",
            "telephone_number": "870-572-5005",
            "fax_number": "870-572-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "KORMYN",
        "middle_name": "SHAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Simmons, RECOVERY ASSISTANT
• Russell Thomas Simmons, O.D.
• Mackenzie Simon, PT
• Tiffany Marie Simpson, OTR/L
• Abby G Sims, MS, CCC-SLP
• Morgan Sims
• Jai Singkhek
• Tamaya Singleton
• Verda Singleton, RECOVERY ASSISTANT
• Y T Singleton, RECOVERY ASSISTANT

• Case Manager/Care Coordinator in Benton, AR
• Providers in Benton, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.