Individual provider Active NPI

Tommy L Sims, PA-C

  • Physician Assistant
  • Rocky Mount, NC
National Provider Identifier
1487628376
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10229 Issued in NC
Practice address
550 N Winstead Ave
Rocky Mount, NC 27804-2231
Phone
(524) 513-4112
Fax
(524) 513-4232
NPI assigned
Feb 15, 2006
Last updated
Apr 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-10229 NC Primary
Physician Assistant 363A00000X PA9101447 FL

Addresses

Primary practice location

550 N Winstead Ave
Rocky Mount, NC 27804-2231

Mailing address

3420 Merrifield Rd
Rocky Mount, NC 27804-2125
Phone (727) 482-0673

Other identifiers 6

IdentifierTypeStateIssuer
017798600MedicaidFL
9677425OtherFLAETNA (FMSG)
1065775OtherFLCAREPLUS (BOA)
292352100OtherFLMEDICAID
Y06TWOtherFLBCBS
7171751OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091116000336 VI Practitioner - Physician Assistant 2466480926 Reassigns benefits to 1 organization
I20200812002130 NC Practitioner - Physician Assistant 2466480926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

1261 Julian Allsbrk Hwy
Roanoke Rapids, NC 27870-5127
Phone (252) 537-5600

2001 Sunset Ave
Rocky Mount, NC 27804-2523
Phone (252) 458-2508

212 N Spence Ave
Goldsboro, NC 27534-4318
Phone (919) 778-0851

2503 Forest Hills Rd W
Suite B
Wilson, NC 27893-3392
Phone (252) 991-0555

2908 N Herritage St
Kinston, NC 28501-1580
Phone (252) 523-3111

315 Greenville Blvd SE
Suite 100
Greenville, NC 27858-5733
Phone (252) 917-5621

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-10229NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopaedics and Sports Medicine Past Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients
Emergency Physician Specialists Inc Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1487628376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 MERRIFIELD RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042125",
            "telephone_number": "727-482-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042231",
            "telephone_number": "524-513-4112",
            "fax_number": "524-513-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "TOMMY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10229",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101447",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017798600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (FMSG)",
            "identifier": "9677425",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS (BOA)",
            "identifier": "1065775",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "292352100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y06TW",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7171751",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.