Active NPI
Andrea Lynnette Samuels, D.C.
- Chiropractor
- Gwynn Oak, MD
National Provider Identifier
1003381377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 03945
- Practice address
- 6340 Security Blvd # a-20
Gwynn Oak, MD 21207-5173 - Phone
- (443) 613-5259
- NPI assigned
- Oct 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 03945 | MD | Primary |
Addresses
Primary practice location
6340 Security Blvd # a-20
Gwynn Oak, MD 21207-5173
Mailing address
5226 Hillwell Rd
Baltimore, MD 21229-3225
Phone (443) 613-5259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03945 | MD | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1003381377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5226 HILLWELL RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212293225",
"telephone_number": "443-613-5259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6340 SECURITY BLVD # A-20",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212075173",
"telephone_number": "443-613-5259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "ANDREA",
"middle_name": "LYNNETTE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-12",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "MD",
"license": "03945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gwynn Oak, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.