Sammie Anderson
Individual provider Active NPI Peer Specialist · Shively, KY
NPI 1104518158 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1104518158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 3934 Dixie Hwy Ste 320
Shively, KY 40216-4198 - Phone
- (502) 830-9460
- NPI assigned
- May 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
3934 Dixie Hwy Ste 320
Shively, KY 40216-4198
Mailing address
6406 Triplett Dr
Louisville, KY 40258-3048
Phone (270) 952-4031
Other practice location 1
108 Daventry Ln Ste 105
Louisville, KY 40223-2849
Phone (270) 952-9299
Other providers in Shively, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.