Individual provider Active NPI

Jahan D Sampson, DC

  • Chiropractor
  • Abingdon, MD
National Provider Identifier
1487652202
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S2070 Issued in MD
Practice address
2953 Emmorton Rd
Abingdon, MD 21009-1631
Phone
(410) 515-6785
Fax
(410) 515-6757
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S2070 MD Primary

Addresses

Primary practice location

2953 Emmorton Rd
Abingdon, MD 21009-1631

Mailing address

9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409
Phone (410) 933-5678

Other identifiers 2

IdentifierTypeStateIssuer
614021OtherMDCAREFIRST
10436136OtherMDCAQH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
S2070MDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1487652202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-933-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2953 EMMORTON RD",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091631",
            "telephone_number": "410-515-6785",
            "fax_number": "410-515-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "JAHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S2070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "614021",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10436136",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.