Samuel Sim, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

110424 Issued in GA

Practice address

1 Medical Park Blvd
Bristol, TN 37620-7430

Phone

(423) 844-1121

NPI assigned

Sep 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA, HI, TN, MI, AZ, GA6 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 6

Specialty

Gastroenterology

Education

University of Alberta, Faculty of Medicine, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Maui Health System a Kaiser Foundation Hospitals LLCGroup PAC ID 9830476159, 52 clinicians

Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013
• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org

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.

• Maui Health System a Kaiser Foundation Hospitals LLC

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Medicare reassignment Care Compare group NPD
• Yuma Regional Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Medicare reassignment Care Compare group NPD
• Advanced Gastroenterology, PLLC

  • Gastroenterology Physician
  • Vancouver, WA
  • NPI 1003992090
  Medicare reassignment Authorized official
• WT Medical Associates

  • Internal Medicine Physician
  • Dyersburg, TN
  • NPI 1295223279
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Advanced Gastroenterology

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1962706655
  NPD Authorized official
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment
• WT Medical Associates

  • Rural Health Clinic/Center
  • Halls, TN
  • NPI 1356176556
  NPD
• WT Medical Associates

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1427604198
  NPD
• Advanced Endoscopy Center, LLC

  • Endoscopy Clinic/Center
  • Vancouver, WA
  • NPI 1619108669
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • Specialist
  • Wailuku, HI
  • NPI 1669834016
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • Family Medicine Physician
  • Kula, HI
  • NPI 1922459726
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston Hospitals Inc

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation
• Yuma Regional Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare affiliation

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1275633844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 SE 164TH AVE STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839313",
            "telephone_number": "360-946-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1390 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853644430",
            "country_code": "US",
            "telephone_number": "928-344-4325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3304 Cooley Ct",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490247430",
            "country_code": "US",
            "telephone_number": "269-349-2266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 Mahalani St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932526",
            "country_code": "US",
            "telephone_number": "808-224-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIM",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "77301",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "110424",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "EMC0004965",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "129513",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD-12112",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00032743",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519043-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000237701",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8179897",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHREVIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Chris Shipley, D. D. S.
• Nancy S Shisler, C.F.N.P.
• Amy Nicole Shortt, ACNP-AG
• William R Shumaker, O.D.
• Jake Sides
• Kelly Carter Simcox, FNP-BC
• Evelyn Faye Simerly, REGISTERED NURSE
• Mara W Sindoni, MA
• Brittney Kestner Skeen
• Samantha Denise Slagle, LCSW

• Gastroenterology Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.