Samirrah Jewel LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SAMIRRAH JEWEL LLC

Practice address

4295 Sebring Walk
Decatur, GA 30034-2493

Phone

(470) 216-9166

NPI assigned

Jan 16, 2024

Organization subpart

No

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

Authorized official

Name

Samirrah Jewel Wright

Title

Prosthetic Orthotic Provider

Phone

(470) 216-9166

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1376304584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 ROSWELL RD STE G3010",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283152",
            "telephone_number": "470-216-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 SEBRING WALK",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342493",
            "telephone_number": "470-216-9166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 Mall Pkwy Ste 730",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300386900",
            "country_code": "US",
            "telephone_number": "470-216-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAMIRRAH JEWEL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "SAMIRRAH",
        "authorized_official_middle_name": "JEWEL",
        "authorized_official_title_or_position": "PROSTHETIC ORTHOTIC PROVIDER",
        "authorized_official_telephone_number": "470-216-9166"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "4045668909",
            "affiliation": "N",
            "endpointDescription": "fax",
            "address_1": "4295 Sebring Walk",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300342493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Decatur, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.