DR. ANTHONY SIMS M.D.
NPI 1992786636
Family Medicine in Henagar, AL

Q: What is Anthony Sims's NPI number?

The NPI number for Anthony Sims is 1992786636. It was assigned to this individual provider in the NPPES registry on November 9, 2005.

Q: What is Anthony Sims's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Sims was last updated on January 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 09, 2005PECOS EnrolledAccepts Medicare Assignment

18324 ALABAMA HIGHWAY 75, HENAGAR, AL 35978(256) 657-1101(256) 657-1115 Get Directions Write a Review

NPPES record last updated: January 25, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Anthony Sims M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANTHONY SIMS M.D. (NPI 1992786636) is an individual family medicine provider in Henagar, Alabama, licensed in Alabama (00024870) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2001).

NPPES Registry Identity

NPI1992786636

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. ANTHONY SIMSCredential: M.D.

Location Address18324 ALABAMA HIGHWAY 75Henagar, AL 35978

Mailing AddressP.o. Box 518Henagar, AL 35978 · (256) 657-1101 · Fax (256) 657-1115

Phone(256) 657-1101

Fax(256) 657-1115

Sole ProprietorYes

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2001

Enumeration DateNovember 9, 2005

Last NPPES UpdateJanuary 25, 2013

✔ NPI 1992786636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AL · 00024870

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

18324 ALABAMA HIGHWAY 75, Henagar, AL 35978

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Other Identifiers 3

Medicare ID-Type Unspecified051522432AL

Medicare UPINH81745AL

Medicaid051522432AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Anthony Sims M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577533900

PECOS Enrollment IDI20040812001118

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

661 services327 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

254 services254 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

209 services138 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

208 services46 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

162 services162 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

123 services123 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

110 services63 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

59 services40 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

57 services48 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

51 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

50 services50 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

50 services50 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

39 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

23 services23 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35978 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

68%4,748 patients3/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

1%200 patients1/55-star benchmark: 96%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

21%1,848 patients1/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%682 patients4/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%1,848 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%1,848 patients1/55-star benchmark: 59%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers48 claims105 services$6.00 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

4 suppliers11 claims12 services$0.89 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

3 suppliers12 claims14 services$61.00 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

4 suppliers12 claims42 services$1.35 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers25 claims25 services$16.62 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers15 claims15 services$48.55 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SUSAN PARKER CRNP

Nurse Practitioner

18324 ALABAMA HIGHWAY 75
HENAGAR, AL 35978

Dekalb County (256) 657-1101

HENAGAR FAMILY MEDICINE, L.L.C.

Family Medicine

18324 ALABAMA HIGHWAY 75
HENAGAR, AL 35978

Dekalb County (256) 657-1101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anthony Sims's NPI number?

The NPI number for Anthony Sims is 1992786636. It was assigned to this individual provider in the NPPES registry on November 9, 2005.

Where is Anthony Sims located?

Anthony Sims practices at 18324 Alabama Highway 75, Henagar, AL 35978. The listed phone number is (256) 657-1101.

What is Anthony Sims's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Anthony Sims enrolled in Medicare?

Yes. Anthony Sims is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Anthony Sims accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Anthony Sims as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anthony Sims was last updated on January 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.