Individual provider Active NPI

Mark A Sims, M.D.

  • Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1932103504
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
038365 Issued in GA
Practice address
95 Collier Rd NW
Ste 4085
Atlanta, GA 30309-1750
Phone
(404) 355-3200
Fax
(404) 355-9819
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 038365 GA Primary

Addresses

Primary practice location

95 Collier Rd NW
Ste 4085
Atlanta, GA 30309-1750

Mailing address

95 Collier Rd NW
Ste 4075
Atlanta, GA 30309-1751
Phone (404) 603-3543

Other identifiers 1

IdentifierTypeStateIssuer
00599156AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000723 GA Practitioner - Gastroenterology 6709946809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038365GAMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1932103504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW",
            "address_2": "STE 4075",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091751",
            "telephone_number": "404-603-3543",
            "fax_number": "404-350-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW",
            "address_2": "STE 4085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091750",
            "telephone_number": "404-355-3200",
            "fax_number": "404-355-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "038365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599156A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.