Active NPI
Jeff Allen Sampson Jr.
- Driver
- Ravenna, OH
National Provider Identifier
1205518842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- UV263581
- Practice address
- 4669 Dewberry Circle
Ravenna, OH 44266 - Phone
- (234) 284-3429
- NPI assigned
- Aug 3, 2023
- Last updated
- Aug 3, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | UV263581 | OH | Primary |
Addresses
Primary practice location
4669 Dewberry Circle
Ravenna, OH 44266
Mailing address
4669 Dewberry Circle
Ravenna, OH 44266
Phone (234) 284-3429
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 |
|---|---|---|---|
| UV263581 | OH | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1205518842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4669 DEWBERRY CIRCLE",
"city": "RAVENNA",
"state": "OH",
"postal_code": "44266",
"telephone_number": "234-284-3429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4669 DEWBERRY CIRCLE",
"city": "RAVENNA",
"state": "OH",
"postal_code": "44266",
"telephone_number": "234-284-3429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "JEFF",
"middle_name": "ALLEN",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-03",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OH",
"license": "UV263581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravenna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.