Individual provider Active NPI

Shiasia Sims

  • Assistant Behavior Analyst
  • Columbia, SC
National Provider Identifier
1619685351
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-25-15802 Issued in SC
Practice address
830 Gracern Rd
Columbia, SC 29210-7629
Phone
(706) 842-5330
Fax
(706) 842-5340
NPI assigned
Nov 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-25-15802 SC Primary
Behavior Technician 106S00000X RBT-22-232279 SC

Addresses

Primary practice location

830 Gracern Rd
Columbia, SC 29210-7629

Mailing address

209 7TH St FL 3
Augusta, GA 30901-1486
Phone (706) 842-5330

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
RBT-22-232279SCMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1619685351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 7TH ST FL 3",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011486",
            "telephone_number": "706-842-5330",
            "fax_number": "706-842-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 GRACERN RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107629",
            "telephone_number": "706-842-5330",
            "fax_number": "706-842-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "SHIASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "SC",
            "license": "0-25-15802",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "SC",
            "license": "RBT-22-232279",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.