Individual provider Active NPI

Sammie O'Neal III, MA, CDC1

  • Counselor
  • Eagle River, AK
National Provider Identifier
1053784314
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
20442 Ptarmigan Blvd
Eagle River, AK 99577-8735
Phone
(907) 406-3033
NPI assigned
Nov 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

20442 Ptarmigan Blvd
Eagle River, AK 99577-8735

Mailing address

2830 Mallard Dr
Greenville, TX 75402-4131
Phone (907) 406-3033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514003124 AK Practitioner - Mental Health Counselor 2062853682 Practice locations: Eagle River, AK

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Eagle River, AK 99577
Phone (907) 406-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
A Lil Bit of Sunshine Mental Health CurrentSince Dec 22, 2020 Accepting new patients

Locations

10928 Eagle River Rd
Ste 148
Eagle River, AK 99577
Phone (907) 406-3033

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1053784314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 MALLARD DR",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754024131",
            "telephone_number": "907-406-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20442 PTARMIGAN BLVD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778735",
            "telephone_number": "907-406-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "SAMMIE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, CDC1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

Verify at the official NPI Registry.