NPIMap

Organization Active NPI

David N. Sim, M.D.,P.a.

  • Medical Specialty Clinic/Center
  • Boise, ID
National Provider Identifier
1750371894
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
M3561 Issued in ID
Legal business name
DAVID N. SIM, M.D.,P.A.
Practice address
6014 W Emerald St
Boise, ID 83704-8855
Phone
(208) 376-8666
Fax
(208) 376-9804
NPI assigned
Oct 27, 2005
Last updated
Oct 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Authorized official

Name
Dr. David Neil Sim, M.D.,P.A.NPI 1114106952
Title
Cardiologist
Phone
(208) 376-8666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X M3561 ID Primary

Addresses

Primary practice location

6014 W Emerald St
Boise, ID 83704-8855

Mailing address

6014 W Emerald St
Boise, ID 83704-8855
Phone (208) 376-8666

Other identifiers 3

IdentifierTypeStateIssuer
000010001844OtherIDBLUE SHIELD
35618OtherIDBLUE CROSS
002451500MedicaidID

National Provider Directory

National Provider Directory

Locations

6014 W Emerald St
Boise, ID 83704
Phone (208) 376-8666

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1750371894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6014 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048855",
            "telephone_number": "208-376-8666",
            "fax_number": "208-376-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6014 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048855",
            "telephone_number": "208-376-8666",
            "fax_number": "208-376-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID N. SIM, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "SIM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "CARDIOLOGIST",
        "authorized_official_telephone_number": "208-376-8666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,P.A."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "ID",
            "license": "M3561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010001844",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "35618",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002451500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.