Active NPI
Samantha R Minott
- Family Nurse Practitioner
- South Orange, NJ
National Provider Identifier
1063980688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 26NJ00659900
- Practice address
- 20 Valley St Ste 320
South Orange, NJ 07079-2881 - Phone
- (973) 313-1113
- NPI assigned
- Nov 13, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ00659900 | NJ | Primary |
Addresses
Primary practice location
20 Valley St Ste 320
South Orange, NJ 07079-2881
Mailing address
37 Mountain Street
Apartment 2
West Orange, NJ 07052
Phone (551) 580-3280
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00659900 | NJ | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1063980688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 MOUNTAIN STREET",
"address_2": "APARTMENT 2",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "07052",
"telephone_number": "551-580-3280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 VALLEY ST STE 320",
"city": "SOUTH ORANGE",
"state": "NJ",
"postal_code": "070792881",
"telephone_number": "973-313-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINOTT",
"first_name": "SAMANTHA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-13",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ00659900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.