Active NPI
Samantha Al Halaseh, D.O.
- Anatomic Pathology Physician
- Fort Payne, AL
National Provider Identifier
1487897971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- DO.1182
- Practice address
- 1211 Big Wills Dr NW
Fort Payne, AL 35967-8238 - Phone
- (310) 413-2299
- NPI assigned
- Apr 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Anatomic Pathology Physician | 207ZP0101X | DO.1182 | AL | Primary |
Addresses
Primary practice location
1211 Big Wills Dr NW
Fort Payne, AL 35967-8238
Mailing address
1211 Big Wills Dr NW
Fort Payne, AL 35967-8238
Phone (310) 413-2299
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO.1182 | AL | MD | Anatomic Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Health & Wellness Center | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1487897971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 BIG WILLS DR NW",
"city": "FORT PAYNE",
"state": "AL",
"postal_code": "359678238",
"telephone_number": "310-413-2299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 BIG WILLS DR NW",
"city": "FORT PAYNE",
"state": "AL",
"postal_code": "359678238",
"telephone_number": "310-413-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL HALASEH",
"first_name": "SAMANTHA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-13",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "AL",
"license": "DO.1182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Payne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.