Individual provider Active NPI

Marquise Sims, ATC

  • Athletic Trainer
  • Augusta, GA
National Provider Identifier
1659815215
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT003447 Issued in GA
Practice address
1701 15TH St
Augusta, GA 30901-3931
Phone
(706) 737-7360
NPI assigned
Dec 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 911300891 GA
Athletic Trainer 2255A2300X AT003447 GA Primary

Addresses

Primary practice location

1701 15TH St
Augusta, GA 30901-3931

Mailing address

1220 W Wheeler Pkwy Ste B
Augusta, GA 30909-1895

Other practice location 1

1240 W McIntosh St
Milledgeville, GA 31061-3170
Phone (706) 951-8583

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
AT003447GAMDAthletic Trainer
911300891GAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1659815215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W WHEELER PKWY STE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309013931",
            "telephone_number": "706-737-7360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 W McIntosh St",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "310613170",
            "country_code": "US",
            "telephone_number": "706-951-8583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MARQUISE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-15",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "911300891",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.