Stacy Latrice Sims, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301092843 Issued in MI

Practice address

699 Church St NE
Suite 220
Marietta, GA 30060-1116

Phone

(770) 422-8505

Fax

(770) 424-7449

NPI assigned

Jul 14, 2008

Last updated

Feb 16, 2017By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Wayne State University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marietta OB GYN Affiliates, P.a.Group PAC ID 2264323187, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13157/brand/3/csg/1/fhir/r4
• Direct secure messaging: stacy.sims.1@13157.direct.athenahealth.com

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.

• Marietta OB GYN Affiliates, P.a.

  • Obstetrics & Gynecology Physician
  • Marietta, GA
  • NPI 1891710679
  Medicare reassignment Care Compare group NPD
• Marietta OB GYN Affiliates, P.a.

  • Obstetrics & Gynecology Physician
  • Marietta, GA
  • NPI 1508882663
  NPD
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Paulding Medical Center, Inc.

  dba Wellstar Paulding Hospital

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435
  Care Compare affiliation

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1689838146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CHURCH STREET",
            "address_2": "SUITE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601116",
            "telephone_number": "770-422-8505",
            "fax_number": "770-424-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "SUITE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601116",
            "telephone_number": "770-422-8505",
            "fax_number": "770-424-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "STACY",
        "middle_name": "LATRICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301092843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003127946A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003127946B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina N Sims, MPT
• Jaimie Sims, COTA/L
• Larae Sims
• Marcuetta D. Sims, PHD
• Richshawna C Sims, LPC
• Zhane Sims
• Gloria Singleton Gaston, MD
• Paula Sinisterra, M.S, NBCC
• Dawn E Sinkola, PT
• Roger Harlon Sisk, M.D.

• Obstetrics & Gynecology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.