Active NPI
Gregory Richard Sims, CRNA
- Certified Registered Nurse Anesthetist
- Hattiesburg, MS
National Provider Identifier
1669475315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- A810169
- Practice address
- 5001 Hardy St
Hattiesburg, MS 39402-1308 - Phone
- (601) 268-8140
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | APN0000010910 | TN | |
| Registered Nurse | 163W00000X | RN0000136483 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | A810169 | MS | Primary |
| Critical Care Medicine Registered Nurse | 163WC0200X | RN863786 | MS |
Addresses
Primary practice location
5001 Hardy St
Hattiesburg, MS 39402-1308
Mailing address
1 Mocking Bird LN
Petal, MS 39465-9640
Phone (601) 618-9852
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04927221 | Medicaid | MS | |
| 1034592 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000136483 | TN | MD | Registered Nurse |
| RN863786 | MS | MD | Critical Care Medicine Registered Nurse |
| A810169 | MS | MD | Certified Registered Nurse Anesthetist |
| APN0000010910 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C & O Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southern Anesthesia Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| QHG of Hattiesburg Inc | Past | Accepting new patients | |
| Hattiesburg Anesthesia Associates, LLC | Past | Accepting new patients |
Locations
139 Fairfield Dr
Hattiesburg, MS 39402
Phone (601) 450-2401
Organizations & group practices 4
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.
-
- Certified Registered Nurse Anesthetist
- Hattiesburg, MS
- NPI 1780025767
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Hattiesburg, MS
- NPI 1396493524
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Hattiesburg, MS
- NPI 1265564041
-
- Emergency Medical Services (Emergency Medicine) Physician
- Hattiesburg, MS
- NPI 1326032400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1669475315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MOCKING BIRD LN",
"city": "PETAL",
"state": "MS",
"postal_code": "394659640",
"telephone_number": "601-618-9852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 HARDY ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021308",
"telephone_number": "601-268-8140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMS",
"first_name": "GREGORY",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN0000010910",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "RN0000136483",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "A810169",
"primary": true
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MS",
"license": "RN863786",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04927221",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1034592",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.