Nadezda Samples, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

291755 Issued in NY

Practice address

3110 Maccorkle Ave SE RM 58
Charleston, WV 25304-1210

Phone

(304) 388-9947

NPI assigned

Jun 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

General Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1376958058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MOUNTAIN TOP CIR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253099642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 MACCORKLE AVE SE RM 58",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041210",
            "telephone_number": "304-388-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "NADEZDA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-21",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "291755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samina Kazmi MD PLLC
• Courtney Sammons
• Karen Jean Sammons
• Deana Thaxton Samms, MA, LPC
• Ramanathan Sampath, MD
• Dakota Sampsell
• Knoshavia Sampson
• Jeremiah Samuels
• Jennifer Sanchez
• Rebecca Sanchez

• General Practice Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.