Individual provider Active NPI

Michael Sims, PTA

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1780873687
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
9089 Clairemont Mesa Blvd
San Diego, CA 92123-1234
Phone
(800) 787-6787
NPI assigned
Oct 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X CA Primary

Addresses

Primary practice location

9089 Clairemont Mesa Blvd
San Diego, CA 92123-1234

Mailing address

3955 Faircross PL Unit 55
#55
San Diego, CA 92115-6569
Phone (225) 205-3015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1780873687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 FAIRCROSS PL UNIT 55",
            "address_2": "#55",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156569",
            "telephone_number": "225-205-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9089 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231234",
            "telephone_number": "800-787-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.