Active NPI
Samantha Nelson
- Other Technician
- Jacksonville, FL
National Provider Identifier
1235531336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- E3044177
- Practice address
- 10948 Raley Creek Dr S
Jacksonville, FL 32225-2324 - Phone
- (904) 888-2928
- NPI assigned
- Sep 19, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | E3044177 | TX | Primary |
Addresses
Primary practice location
10948 Raley Creek Dr S
Jacksonville, FL 32225-2324
Mailing address
10948 Raley Creek Dr S
Jacksonville, FL 32225-2324
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 |
|---|---|---|---|
| E3044177 | TX | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1235531336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10948 RALEY CREEK DR S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322252324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10948 RALEY CREEK DR S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322252324",
"telephone_number": "904-888-2928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-19",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "TX",
"license": "E3044177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.