Elizabeth Sam

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9874 Issued in AZ

Practice address

18275 N 59TH Ave
#138
Glendale, AZ 85308-1260

Phone

(602) 564-0078

NPI assigned

Feb 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1447798590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "STE 138",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081253",
            "telephone_number": "623-792-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "#138",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081260",
            "telephone_number": "602-564-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitali Madhu Salklan, MD
• Lindsey K Salute, DPT
• Madhu Salvaji, D.O.
• Gary Salwin, D.D.S.
• Sam Understands Counseling, LLC (LifeTree Counseling)
• Sam's Club Optical (Sam's Club Optical 30-4732)
• Shimran Samantaray
• Nisal K Samarasekera, M.D.
• Allyson Sambach, DNP, PMHNP-BC
• Jessica Icha Sambrano, MS, LAC

• Family Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.