Active NPI
Samantha Rae Stapleton
- Social Worker
- Jackson, OH
National Provider Identifier
1205182177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S0900850
- Practice address
- 731 E Main St
Suite16
Jackson, OH 45640-2100 - Phone
- (740) 286-5245
- Fax
- (740) 286-7642
- NPI assigned
- Jul 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S0900850 | OH | Primary |
Addresses
Primary practice location
731 E Main St
Suite16
Jackson, OH 45640-2100
Mailing address
731 E Main St
Suite16
Jackson, OH 45640-2100
Phone (740) 286-5245
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
| License | State | Type | Specialty |
|---|---|---|---|
| S0900850 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1205182177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 E MAIN ST",
"address_2": "SUITE16",
"city": "JACKSON",
"state": "OH",
"postal_code": "456402100",
"telephone_number": "740-286-5245",
"fax_number": "740-286-7642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 E MAIN ST",
"address_2": "SUITE16",
"city": "JACKSON",
"state": "OH",
"postal_code": "456402100",
"telephone_number": "740-286-5245",
"fax_number": "740-286-7642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLETON",
"first_name": "SAMANTHA",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-30",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S0900850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.