Individual provider Active NPI

Samaria S James, RN

  • Developmentally Disabled Services Day Training Agency
  • Palm Coast, FL
National Provider Identifier
1134462278
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
RN9376787 Issued in FL
Practice address
76 Seattle TRL
Palm Coast, FL 32164-5530
Phone
(386) 627-2066
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X RN9376787 FL
Developmentally Disabled Services Day Training Agency 251C00000X RN9376787 FL Primary

Addresses

Primary practice location

76 Seattle TRL
Palm Coast, FL 32164-5530

Mailing address

76 Seattle TRL
Palm Coast, FL 32164-5530
Phone (386) 627-2066

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9376787FLMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1134462278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 SEATTLE TRL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645530",
            "telephone_number": "386-627-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SEATTLE TRL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645530",
            "telephone_number": "386-627-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "SAMARIA",
        "middle_name": "S",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "RN9376787",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "RN9376787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.