Krystal Abygayle Samuel

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

30 Waters Edge LN
Covington, GA 30014-5035

Phone

(516) 492-1786

NPI assigned

May 5, 2025

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1194514125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WATERS EDGE LN",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300145035",
            "telephone_number": "516-492-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WATERS EDGE LN",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300145035",
            "telephone_number": "516-492-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "KRYSTAL",
        "middle_name": "ABYGAYLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Saddler, C.N.A
• Safeguard Emergency Physicians, LLC
• Sage Dental Group of Georgia, LLC (Sage Dental of Covington)
• Asha Said
• Salem Pharmacy LLC (Salem Pharmacy)
• Sherley C Samuels, M.D.
• Nathan Gabriel Manarang San Felipe
• Danielle Ashlene Sanders-Pacheco, BCBA
• Fredniki Ladoris Sanders, CRNP
• Ruquiyah Sanders, LDO

• Student in an Organized Health Care Education/Training Program in Covington, GA
• Providers in Covington, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.