Individual provider Active NPI

Shanlee Samson

  • Counselor
  • Bethel, AK
National Provider Identifier
1497147920
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
833 Chief Eddie Hoffman Highway
Bethel, AK 99559
Phone
(907) 543-6465
NPI assigned
Feb 20, 2015
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

833 Chief Eddie Hoffman Highway
Bethel, AK 99559

Mailing address

PO Box 528
Appn: BH CRC Program
Bethel, AK 99559-0528

Other identifiers 1

IdentifierTypeStateIssuer
1020986MedicaidAK

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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1497147920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "address_2": "APPN: BH CRC PROGRAM",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHIEF EDDIE HOFFMAN HIGHWAY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "SHANLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020986",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.