Individual provider Active NPI

Lisa Sims, NP

  • Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1235341017
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN1155250 Issued in GA
Practice address
203 Medical Blvd
Stockbridge, GA 30281-7218
Phone
(770) 892-0273
Fax
(470) 878-1495
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN1155250 GA Primary

Addresses

Primary practice location

203 Medical Blvd
Stockbridge, GA 30281-7218

Mailing address

203 Medical Blvd
Stockbridge, GA 30281-7218
Phone (770) 892-0273

Other identifiers 2

IdentifierTypeStateIssuer
003144411BMedicaidGA
003144411AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140430000171 GA Practitioner - Nurse Practitioner 3072746965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenerative Orthopaedics and Spine Institute LLCGroup PAC ID 8729397617, 11 clinicians

Practice addresses (Care Compare)

135 N Park PL
Suite 101
Stockbridge, GA 30281-7237
Phone (770) 892-0273

Merit-based Incentive Payment System (MIPS)

Final score
82.64 of 100Reported as group
Quality
69.91
Promoting interoperability
100
Improvement activities
40
Cost
72.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1155250GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Orthopaedics and Spine Institute, LLC CurrentSince Oct 19, 2015 Accepting new patients
Regenerative Orthopaedics and Spine Institute, LLC CurrentSince Oct 19, 2015 Accepting new patients

Locations

680 S 9th St
Griffin, GA 30224
Phone (478) 719-8895

135 N Park Pl
Ste 210
Stockbridge, GA 30281
Phone (770) 892-0273

203 Medical Blvd
Stockbridge, GA 30281
Phone (678) 604-5070

135 N Park Pl
Ste 101
Stockbridge, GA 30281
Phone (770) 892-0273

135 N Park Pl
Ste 220
Stockbridge, GA 30281
Phone (770) 892-0300

Interoperability endpoints

  • Direct secure messaging: lisa.sims.1@12239.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1235341017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817218",
            "telephone_number": "770-892-0273",
            "fax_number": "470-878-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817218",
            "telephone_number": "770-892-0273",
            "fax_number": "470-878-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN1155250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144411B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144411A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.