Individual provider Active NPI

Robert Sims Sr., LBSW

  • Case Manager/Care Coordinator
  • Wayne, MI
National Provider Identifier
1457730210
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
6802061483 Issued in MI
Practice address
35425 W Michigan Ave
Wayne, MI 48184-9800
Phone
(734) 467-7600
Fax
(734) 467-7646
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802061483 MI
Case Manager/Care Coordinator 171M00000X 6802061483 MI Primary

Addresses

Primary practice location

35425 W Michigan Ave
Wayne, MI 48184-9800

Mailing address

35425 W Michigan Ave
Wayne, MI 48184-9800
Phone (313) 850-8409

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

LicenseStateTypeSpecialty
6802061483MIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1457730210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35425 W MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481849800",
            "telephone_number": "313-850-8409",
            "fax_number": "734-467-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35425 W MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481849800",
            "telephone_number": "734-467-7600",
            "fax_number": "734-467-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802061483",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6802061483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.