Individual provider Active NPI

Brenda Neshell Sims, FNP

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1407348337
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.017659 Issued in IL
Practice address
4215 Newburg Rd
Rockford, IL 61108-6479
Phone
(815) 988-8500
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 209.017659 IL Primary

Addresses

Primary practice location

4215 Newburg Rd
Rockford, IL 61108-6479

Mailing address

4215 Newburg Rd
Rockford, IL 61108-6479
Phone (815) 988-8500

Other practice location 1

2350 Royal Blvd
Elgin, IL 60123-4719
Phone (847) 695-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190212000605 IL Practitioner - Nurse Practitioner 0547508814 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elio M Vento MD and Associates SCGroup PAC ID 4284688748, 8 clinicians

Practice addresses (Care Compare)

2350 Royal Blvd
Suite 100
Elgin, IL 60123-4718
Phone (847) 695-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.017659ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Emergency Physicians, LTD CurrentSince Oct 1, 2020 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 1, 2019 Accepting new patients
Crystal Lake Immediate Care Physicians LTD. CurrentSince Oct 1, 2020 Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 1, 2019 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 8, 2021 Accepting new patients
Elio M Vento MD & Associates SC CurrentSince Oct 19, 2021 Accepting new patients
In Home Medical Group LLC CurrentSince Jul 8, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 8, 2021 Accepting new patients
Cardinalight Health, LLC PastSince Oct 19, 2021 Accepting new patients
Advocate Health and Hospitals Corporation PastSince Oct 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

525 E Congress Pkwy
Ste 100
Crystal Lake, IL 60014
Phone (626) 327-6795

2350 Royal Blvd
Ste 100
Elgin, IL 60123
Phone (847) 695-8100

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

4215 Newburg Rd
Rockford, IL 61108
Phone (815) 988-8500

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21874/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDBJBA

Organizations & group practices 11

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1407348337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Royal Blvd",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601234719",
            "country_code": "US",
            "telephone_number": "847-695-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMS",
        "first_name": "BRENDA",
        "middle_name": "NESHELL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.017659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.