Individual provider Active NPI

Samantha A Gomez, LPN

  • Licensed Practical Nurse
  • Fall River, MA
National Provider Identifier
1104595412
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
65413LPN Issued in MA
Practice address
181 Arizona St
Fall River, MA 02723-3226
Phone
(508) 837-0475
NPI assigned
Sep 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 65413LPN MA Primary

Addresses

Primary practice location

181 Arizona St
Fall River, MA 02723-3226

Mailing address

181 Arizona St
Fall River, MA 02723-3226
Phone (508) 837-0475

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

State licenses

LicenseStateTypeSpecialty
65413LPNMAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1104595412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 ARIZONA ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027233226",
            "telephone_number": "508-837-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ARIZONA ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027233226",
            "telephone_number": "508-837-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "65413LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.