Individual provider Active NPI

Samantha Elizabeth Sims, MSW

  • Clinical Social Worker
  • Madison, AL
National Provider Identifier
1750713558
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3672C Issued in AL
Practice address
350 Sun Temple Dr
Madison, AL 35758-5919
Phone
(256) 975-4291
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 3017G AL
Clinical Social Worker 1041C0700X 3672C AL Primary

Addresses

Primary practice location

350 Sun Temple Dr
Madison, AL 35758-5919

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 975-4291

Other names 1

  • Samantha Ousley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230331000880 AL Practitioner - Clinical Social Worker 9335514561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russellville Hospital Inc.Group PAC ID 3476878489, 66 clinicians
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

15225 Hwy 43
Suite I
Russellville, AL 35653-1969
Phone (256) 331-2700

350 Sun Temple Dr
Madison, AL 35758-5919
Phone (256) 288-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3017GALMDSocial Worker
3672CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Russellville Hospital Inc CurrentSince Mar 1, 2023 Accepting new patients
Integrated Behavioral Health, Inc. Social Worker CurrentSince Apr 3, 2023 Accepting new patients
Russellville Hospital Inc CurrentSince Mar 1, 2023 Accepting new patients

Locations

350 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1750713558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-975-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585919",
            "telephone_number": "256-975-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "3017G",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3672C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "OUSLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.