Active NPI
Tyler James Sims
- Social Worker
- Canton, OH
National Provider Identifier
1346815313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2005381
- Practice address
- 4368 Dressler Rd NW
Canton, OH 44718-2771 - Phone
- (330) 433-1300
- Fax
- (330) 494-0828
- NPI assigned
- May 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2005381 | OH | Primary |
Addresses
Primary practice location
4368 Dressler Rd NW
Canton, OH 44718-2771
Mailing address
1222 Shadyside Ave SW
Canton, OH 44710-2050
Phone (330) 488-7587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2005381 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621728000000",
"number": "1346815313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 SHADYSIDE AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447102050",
"telephone_number": "330-488-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4368 DRESSLER RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182771",
"telephone_number": "330-433-1300",
"fax_number": "330-494-0828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMS",
"first_name": "TYLER",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-23",
"last_updated": "2021-05-23",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2005381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.