Individual provider Active NPI

Samantha Deane Hartman, MS

  • Counselor
  • Johns Creek, GA
National Provider Identifier
1053947697
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
APC00702 Issued in GA
Practice address
10700 State Bridge Rd Ste 6
Johns Creek, GA 30022-7491
Phone
(770) 802-8019
NPI assigned
Mar 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X APC00702 GA Primary

Addresses

Primary practice location

10700 State Bridge Rd Ste 6
Johns Creek, GA 30022-7491

Mailing address

112 Hampton Dr
Sandy Springs, GA 30350-3901
Phone (478) 919-8293

Other practice location 1

2850 Johnson Ferry Rd Ste 250
Marietta, GA 30062-8317
Phone (478) 919-8293

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
Master of Science

State licenses

LicenseStateTypeSpecialty
APC00702GAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1053947697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HAMPTON DR",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303503901",
            "telephone_number": "478-919-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 STATE BRIDGE RD STE 6",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300227491",
            "telephone_number": "770-802-8019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 Johnson Ferry Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300628317",
            "country_code": "US",
            "telephone_number": "478-919-8293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "SAMANTHA",
        "middle_name": "DEANE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC00702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

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