Mary Lee Sims, CUSTOM FITTER

Primary specialty

SpecialistTaxonomy code 174400000X

License

9830734 Issued in FL

Practice address

250 Bonita Dr
Merritt Island, FL 32952-5102

Phone

(321) 453-4034

NPI assigned

Jan 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932252608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BONITA DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525102",
            "telephone_number": "321-453-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BONITA DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525102",
            "telephone_number": "321-453-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CUSTOM FITTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "9830734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscila Rosal Siaga Jenkins, RN
• Anthony John Sidor, D.D.S.
• Sigfredo Acosta Perez M.D. P.a. (Merritt Island Pediatrics)
• David Paul Sims, MD
• Jennifer April Sims, RMHCI
• Vanesha Singletary, RBT
• Ambria Skibbe
• Marsha Smirnov, D.C., FICPA
• Carrie Smith
• Charles Smith III, EMS

• Specialist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.