Individual provider Active NPI

Stephen Douglas Sims, D.D.S.

  • General Practice Dentistry
  • Chattanooga, TN
National Provider Identifier
1568676716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS003591 Issued in TN
Practice address
4700 Brainerd Rd
Chattanooga, TN 37411-3827
Phone
(423) 622-5900
Fax
(423) 622-9444
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS003591 TN Primary

Addresses

Primary practice location

4700 Brainerd Rd
Chattanooga, TN 37411-3827

Mailing address

4700 Brainerd Rd
Chattanooga, TN 37411-3827
Phone (423) 622-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224000679 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5890090146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS003591TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568676716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113827",
            "telephone_number": "423-622-5900",
            "fax_number": "423-622-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113827",
            "telephone_number": "423-622-5900",
            "fax_number": "423-622-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "STEPHEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS003591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.