Samuel L Preston III, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0102201883 Issued in VA

Practice address

500 Joel Loop
Ft. Campbell, KY 42223

Phone

(270) 798-8042

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1043479850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 GEORGIA AVE NW",
            "address_2": "WALTER REED AMC BLG. 6, 3RD FLOOR, ADULT BHC",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203070003",
            "telephone_number": "202-782-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JOEL LOOP",
            "city": "FT. CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "SAMUEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201883",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102201883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Bleak Powell, DDS
• Vladmir Powell, RN
• Jonathan R Poyourow, R.D.
• Gordon Troy Prairie, MD
• Hilary Preston, LCSW
• Jarred Lloyd Price, DDS
• Joel Price, LCSW
• Tammy Price
• Angela June Priko, RN NCM
• Kevin Jon Pufall, P.T.

• Psychiatry Physician in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.