Charles Lewis Sims Jr., PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA10600 Issued in CA

Practice address

351 N MTN View Ave
San Bernardino, CA 92415-0010

Phone

(909) 387-6222

Fax

(909) 387-6228

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023

  CA

  Medicare reassignment
• County of San Bernardino

  • Clinical Medical Laboratory
  • Ontario, CA
  • NPI 1043281561
  NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, CA
  • NPI 1346950904
  NPD
• County of San Bernardino

  • Public Health or Welfare Agency
  • Barstow, CA
  • NPI 1073783239
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1679503189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GOLDEN SHR",
            "address_2": "MOLINA MEDICAL CENTERS SMO",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024202",
            "telephone_number": "909-624-4952",
            "fax_number": "909-621-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 N MTN VIEW AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150010",
            "telephone_number": "909-387-6222",
            "fax_number": "909-387-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "CHARLES",
        "middle_name": "LEWIS",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA10600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PA10600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhynique Simon
• Simone Support Services Inc.
• Sharon Simons, M.B.B.S
• Brenda Sue Simpson Hamamoto, M.S.W, L.C.S.W.
• Malaysia Simpson
• Jessica Sims
• Xandria Sims
• Mary Kay Singelman
• Amanjung Singh
• Jyotila Singh, M.D.

• All providers in San Bernardino, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.