Individual provider Active NPI

Samuel Anthony Namey, DO

  • Emergency Medicine Physician
  • Conneaut, OH
National Provider Identifier
1376506410
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34004038 Issued in OH
Practice address
158 West Main Street
Conneaut, OH 44030
Phone
(440) 593-1131
Fax
(330) 656-5901
NPI assigned
Apr 10, 2006
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34004038 OH Primary

Addresses

Primary practice location

158 West Main Street
Conneaut, OH 44030

Mailing address

5700 Darrow Rd
Suite 106
Hudson, OH 44236-5021
Phone (330) 656-9304

Other identifiers 3

IdentifierTypeStateIssuer
0778225MedicaidOH
000000269066OtherOHANTHEM
N368734OtherOHWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100310000322 OH Practitioner - Emergency Medicine 3779577879 Reassigns benefits to 2 organizations
I20220207000180 PA Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 3779577879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34004038OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Conneaut Medical Center CurrentSince Dec 5, 2017 Accepting new patients
University Hospitals Conneaut Medical Center CurrentSince Dec 5, 2017 Accepting new patients
OB-GYN Associates of Erie, PC CurrentSince Sep 22, 2024 Accepting new patients
University Hospitals Conneaut Medical Center Current Accepting new patients
Ues Geauga, LLC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
BMH Professional Corporation Past Accepting new patients
Brown Memorial Hospital Emergency Medicine Past Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

13207 Ravenna Rd
Chardon, OH 44024
Phone (440) 285-5004

158 W Main Rd
Conneaut, OH 44030
Phone (216) 844-3777

100 Peach St
Ste 300
Erie, PA 16507
Phone (814) 459-1851

2861 W 26th St
Ste 1
Erie, PA 16506
Phone (814) 480-7760

Interoperability endpoints

  • Direct secure messaging: samuel.namey.1@27404.direct.athenahealth.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1376506410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DARROW RD",
            "address_2": "SUITE 106",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365021",
            "telephone_number": "330-656-9304",
            "fax_number": "330-656-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WEST MAIN STREET",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "44030",
            "telephone_number": "440-593-1131",
            "fax_number": "330-656-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMEY",
        "first_name": "SAMUEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34004038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0778225",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000269066",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N368734",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conneaut, OH

Sources for this page

Verify at the official NPI Registry.