Individual provider Active NPI

Gregory Richard Sims, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
National Provider Identifier
1669475315
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
A810169 Issued in MS
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

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
04927221MedicaidMS
1034592MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071018000495 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385695113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN0000136483TNMDRegistered Nurse
RN863786MSMDCritical Care Medicine Registered Nurse
A810169MSMDCertified Registered Nurse Anesthetist
APN0000010910TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
C & O Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2022 Accepting new patients
Southern Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2013 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.

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.

Verify at the official NPI Registry.