Individual provider Active NPI

Samantha Rene Johnson

  • In Home Supportive Care Agency
  • Culloden, WV
National Provider Identifier
1144933383
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
99 2ND St
Culloden, WV 25510-7686
Phone
(304) 824-5441
NPI assigned
Jan 3, 2023
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

99 2ND St
Culloden, WV 25510-7686

Mailing address

137 3Rd St
Culloden, WV 25510-7625
Phone (304) 545-5233

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

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1144933383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 3RD ST",
            "city": "CULLODEN",
            "state": "WV",
            "postal_code": "255107625",
            "telephone_number": "304-545-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 2ND ST",
            "city": "CULLODEN",
            "state": "WV",
            "postal_code": "255107686",
            "telephone_number": "304-824-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culloden, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.