Active NPI
Larry Sims, PA
- Physician Assistant
- Knoxville, TN
National Provider Identifier
1891821674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1707
- Practice address
- 900 E Woodland Ave
Knoxville, TN 37917-4511 - Phone
- (865) 633-9469
- Fax
- (865) 633-9474
- NPI assigned
- Feb 26, 2007
- Last updated
- Jun 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TL1298 | SC | |
| Physician Assistant | 363A00000X | 1707 | TN | Primary |
Addresses
Primary practice location
900 E Woodland Ave
Knoxville, TN 37917-4511
Mailing address
900 E Woodland Ave
Knoxville, TN 37917-4511
Phone (865) 633-9469
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9104089 | Other | FL | PA MEDICAL LICENSE |
| TL1298 | Other | SC | SC LICENSE |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1707 | TN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dyersburg Clinic Corp | Past | Accepting new patients | |
| Smokey Mountain Adult Care | Past | Accepting new patients | |
| Coastal Carolina Urology Group, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Dyersburg, TN
- NPI 1093710568
-
- Pain Medicine (Anesthesiology) Physician
- Seymour, TN
- NPI 1144504291
-
- Urology Physician
- Beaufort, SC
- NPI 1528101664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1891821674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 E WOODLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379174511",
"telephone_number": "865-633-9469",
"fax_number": "865-633-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E WOODLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379174511",
"telephone_number": "865-633-9469",
"fax_number": "865-633-9474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMS",
"first_name": "LARRY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "TL1298",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "1707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA MEDICAL LICENSE",
"identifier": "PA9104089",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC LICENSE",
"identifier": "TL1298",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.