Alexander P Samuel, M.D

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

0101247465 Issued in VA

Practice address

111 N South St
1St Floor
Farmville, VA 23901-1354

Phone

(443) 392-3984

Fax

(434) 392-1038

NPI assigned

Jun 30, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1083925523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N SOUTH ST",
            "address_2": "1ST FLOOR",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011354",
            "telephone_number": "443-392-3984",
            "fax_number": "434-392-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N SOUTH ST",
            "address_2": "1ST FLOOR",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011354",
            "telephone_number": "443-392-3984",
            "fax_number": "434-392-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ALEXANDER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "VA",
            "license": "0101247465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodrigo C Roldan, M.D.
• Tara Ross-Barksdale, LPC, MA
• Cynthia A Runnells, CRNA
• S.a.Martin, Jr. OD PC
• Safe Harbor Retreat LLC
• Barbara Ann San, P.T.
• Luke San, M.D.
• Jeffrey Sargent, LPTA
• Brittany Williams Scott, LPC
• Lorna Murtland Secondi, LCSW

• Public Health & General Preventive Medicine Physician in Farmville, VA
• Providers in Farmville, VA by specialty
• Public Health & General Preventive Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.