Individual provider Active NPI

Samuel Mejia

  • Private Vehicle
  • Kent, OH
National Provider Identifier
1235945528
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
License
TM644760 Issued in OH
Practice address
1466 Brimfield Dr
Kent, OH 44240-6941
Phone
(216) 246-5523
NPI assigned
Dec 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X TM644760 OH Primary

Addresses

Primary practice location

1466 Brimfield Dr
Kent, OH 44240-6941

Mailing address

1466 Brimfield Dr
Kent, OH 44240-6941
Phone (216) 246-5523

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

LicenseStateTypeSpecialty
TM644760OHMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1235945528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1466 BRIMFIELD DR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406941",
            "telephone_number": "216-246-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 BRIMFIELD DR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406941",
            "telephone_number": "216-246-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OH",
            "license": "TM644760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.