Individual provider Active NPI

Samuel Yimamu, PHARMD

  • Pharmacist
  • Leonardtown, MD
National Provider Identifier
1063872398
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23114 Issued in MD
Practice address
26020 Point Lookout Rd
Leonardtown, MD 20650-2001
Phone
(301) 475-8917
Fax
(301) 997-0054
NPI assigned
Feb 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23114 MD Primary

Addresses

Primary practice location

26020 Point Lookout Rd
Leonardtown, MD 20650-2001

Mailing address

26020 Point Lookout Rd
Leonardtown, MD 20650-2001
Phone (301) 475-8917

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
23114MDMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1063872398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26020 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502001",
            "telephone_number": "301-475-8917",
            "fax_number": "301-997-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26020 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502001",
            "telephone_number": "301-475-8917",
            "fax_number": "301-997-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIMAMU",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "23114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.