Active NPI
Samuel Adams
- Community Health Worker
- Sandy, UT
National Provider Identifier
1356096622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 9045 S 1300 E Ste 200
Sandy, UT 84094-3134 - Phone
- (801) 666-6834
- NPI assigned
- Feb 15, 2022
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
9045 S 1300 E Ste 200
Sandy, UT 84094-3134
Mailing address
9045 S 1300 E Ste 200
Sandy, UT 84094-3134
Phone (801) 666-6834
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1356096622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9045 S 1300 E STE 200",
"city": "SANDY",
"state": "UT",
"postal_code": "840943134",
"telephone_number": "801-666-6834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9045 S 1300 E STE 200",
"city": "SANDY",
"state": "UT",
"postal_code": "840943134",
"telephone_number": "801-666-6834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-02-15",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.