Individual provider Active NPI

Randall Scott Sims, LCSW

  • Clinical Social Worker
  • Greeley, CO
National Provider Identifier
1316399686
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09924030 Issued in CO
Practice address
5890 W 13TH St
Sutie 114
Greeley, CO 80634-4821
Phone
(970) 810-5456
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09924030 CO Primary

Addresses

Primary practice location

5890 W 13TH St
Sutie 114
Greeley, CO 80634-4821

Mailing address

5890 W 13TH St
Sutie 114
Greeley, CO 80634-4821
Phone (970) 810-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722000192 CO Practitioner - Clinical Social Worker 0143513523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4115 Boardwalk Dr
Unit 100
Fort Collins, CO 80525-5945
Phone (970) 493-4580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09924030COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurofeedback Clinic of Northern Colorado LLC Clinical CurrentSince Jan 9, 2025 Accepting new patients
Neurofeedback Clinic of Northern Colorado LLC Clinical CurrentSince Jan 9, 2025 Accepting new patients

Locations

4115 Boardwalk Dr
Unit 100
Fort Collins, CO 80525
Phone (970) 493-4580

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1316399686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 W 13TH ST",
            "address_2": "SUTIE 114",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344821",
            "telephone_number": "970-810-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 W 13TH ST",
            "address_2": "SUTIE 114",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344821",
            "telephone_number": "970-810-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.