Samuel W Vallery, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

E0503 Issued in AR

Practice address

2212 Malvern Ave
Suite 8
Hot Springs, AR 71901-8038

Phone

(501) 609-2300

Fax

(501) 609-2301

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2218/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CHI St. Vincent Medical Group Hot Springs

  • Specialist
  • Hot Springs, AR
  • NPI 1831387117
  NPD (past)
• Hot Springs MRI Center

  • Magnetic Resonance Imaging Radiologic Technologist
  • Hot Springs, AR
  • NPI 1801896410
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1033110556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W GROVE ST STE 1",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304469",
            "telephone_number": "870-863-2368",
            "fax_number": "870-875-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 MALVERN AVE",
            "address_2": "SUITE 8",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719018038",
            "telephone_number": "501-609-2300",
            "fax_number": "501-609-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLERY",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "E0503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5J718",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00470953",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "16278000001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166792002",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.vallery.1@2218.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "704 W Grove St Ste 1",
            "city": "El Dorado",
            "state": "AR",
            "country_code": "US",
            "postal_code": "717304469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Awaz Upadhayaya
• US Dental
• Nikki Marie Uzick
• Conni J Valencia
• Valerie Swearingen Counseling, Inc.
• Nadiya Valrie, QBHP
• Richard Vanbebber, D.D.S.
• William Nicholas Vanbebber, D.D.S.
• Whitney Vandiver
• Shalimar May Vanquiray, PT

• Otolaryngology Physician in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Otolaryngology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.