Individual provider Active NPI

Samara Lynn Brown Eldridge

  • Home Health Aide
  • Youngstown, OH
National Provider Identifier
1407526189
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
111 N Hartford Ave
Youngstown, OH 44509-2321
Phone
(330) 531-0965
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

111 N Hartford Ave
Youngstown, OH 44509-2321

Mailing address

111 N Hartford Ave
Youngstown, OH 44509-2321
Phone (330) 531-0965

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL Samarasno42@gmail.com Direct

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1407526189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N HARTFORD AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092321",
            "telephone_number": "330-531-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HARTFORD AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092321",
            "telephone_number": "330-531-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN ELDRIDGE",
        "first_name": "SAMARA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Samarasno42@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Not personal email not really sure what an endpoint is",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 N Hartford Ave",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445092321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.