Active NPI
Graciela Sophia Samudio
- Student in an Organized Health Care Education/Training Program
- Lexington, KY
National Provider Identifier
1053229955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 780 Rose Street
Lexington, KY 40536-0001 - Phone
- (859) 446-9819
- NPI assigned
- Aug 31, 2026
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | KY | Primary |
Addresses
Primary practice location
780 Rose Street
Lexington, KY 40536-0001
Mailing address
3000 Brookwood Dr Apt 3
Edgewood, KY 41017-3295
Phone (859) 446-9819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1053229955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 BROOKWOOD DR APT 3",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173295",
"telephone_number": "859-446-9819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 ROSE STREET",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360001",
"telephone_number": "859-446-9819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUDIO",
"first_name": "GRACIELA",
"middle_name": "SOPHIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-31",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.