Provider Demographics
NPI:1215007117
Name:SIMS, PAIGE CAROLINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:CAROLINE
Last Name:SIMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-2798
Mailing Address - Country:US
Mailing Address - Phone:405-556-1808
Mailing Address - Fax:
Practice Address - Street 1:3409 S BROADWAY # 802
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4129
Practice Address - Country:US
Practice Address - Phone:405-285-4017
Practice Address - Fax:405-285-4022
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK244507002Medicare ID - Type UnspecifiedPHYSICAL THERAPIST ID #