Stephanie Ann Sims

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

57122 Issued in ID

Practice address

611 Tanglewood Dr
Rexburg, ID 83440-4915

Phone

(219) 477-9705

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1912477993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 TANGLEWOOD DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834404915",
            "telephone_number": "219-477-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 TANGLEWOOD DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834404915",
            "telephone_number": "219-477-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95061173",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "57122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Shore, LCSW
• Adam Louis Shurtz, DPT
• Alicia G Siddoway, RPT
• Matthew Galland Silva
• Gracie Allene Simmons
• Steven G Sjoblom, CCC-SLP
• Skinlab 360 Dermatology & Aesthetics LLC
• Brandi E Slachter, BSRPH
• Sleep DDS LLC
• Alan R Smith, D.C.

• Registered Nurse in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.