Samson Kanla Orusa, M.D

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

28275 Issued in TN

Practice address

261 Stonecrossing Dr
Clarksville, TN 37042-8404

Phone

(931) 906-4366

Fax

(931) 906-4365

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346388568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 STONECROSSING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370428404",
            "telephone_number": "931-906-4366",
            "fax_number": "931-906-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 STONECROSSING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370428404",
            "telephone_number": "931-906-4366",
            "fax_number": "931-906-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORUSA",
        "first_name": "SAMSON",
        "middle_name": "KANLA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TN",
            "license": "28275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Russell Orr, O.D.
• Hannah Orrison
• Elise Marie Ortega-Cespedes
• Alexis Ortiz
• Charleigh Ortiz
• Joanna Osborne
• Keyana Oshiomha
• Kelly Osmon, RBT
• Ashley Otero-Robles
• Orbie Ottey Jr., D.D.S.

• Adolescent Medicine (Internal Medicine) Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Adolescent Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.