Individual provider Active NPI

Sammy Dallas Maples, PHARMD

  • Pharmacist
  • Punta Gorda, FL
National Provider Identifier
1033456652
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS49820 Issued in FL
Practice address
357 Coldeway Dr
Punta Gorda, FL 33950-5285
Phone
(405) 708-3465
NPI assigned
Jan 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS49820 FL Primary

Addresses

Primary practice location

357 Coldeway Dr
Punta Gorda, FL 33950-5285

Mailing address

357 Coldeway Dr
Punta Gorda, FL 33950-5285
Phone (405) 708-3465

Other identifiers 1

IdentifierTypeStateIssuer
PS49820OtherFLSTATE LICENSE

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS49820FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1033456652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 COLDEWAY DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339505285",
            "telephone_number": "405-708-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 COLDEWAY DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339505285",
            "telephone_number": "405-708-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAPLES",
        "first_name": "SAMMY",
        "middle_name": "DALLAS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS49820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PS49820",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.