Individual provider Active NPI

Carol J Sams, CNP

  • Nurse Practitioner
  • Mayfield Village, OH
National Provider Identifier
1255358867
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP4816 Issued in OH
Practice address
730 Som Center Rd
Suite 240
Mayfield Village, OH 44143-2350
Phone
(440) 720-3230
Fax
(216) 201-7205
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP4816 OH Primary

Addresses

Primary practice location

730 Som Center Rd
Suite 240
Mayfield Village, OH 44143-2350

Mailing address

730 Som Center Rd
Suite 240
Mayfield Village, OH 44143-2350
Phone (440) 720-3230

Other identifiers 1

IdentifierTypeStateIssuer
2125819MedicaidOH

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP4816OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Hospice of Northeast Past Accepting new patients
Olmsted Health & Services Corp. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1255358867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 SOM CENTER RD",
            "address_2": "SUITE 240",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432350",
            "telephone_number": "440-720-3230",
            "fax_number": "216-201-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SOM CENTER RD",
            "address_2": "SUITE 240",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432350",
            "telephone_number": "440-720-3230",
            "fax_number": "216-201-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP4816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125819",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.