Individual provider Active NPI

Samantha Jayne Holm, PHARMD

  • Pharmacist
  • Valley City, ND
National Provider Identifier
1497181838
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH5596 Issued in ND
Practice address
120 W Main St
Valley City, ND 58072-3319
Phone
(701) 845-1763
Fax
(701) 845-5171
NPI assigned
Sep 17, 2013
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH5596 ND Primary

Addresses

Primary practice location

120 W Main St
Valley City, ND 58072-3319

Mailing address

956 6TH Ave NE
Valley City, ND 58072-2347
Phone (701) 430-0180

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH5596NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
White Drug Co of Jamestown Inc PastSince Jul 28, 2019 Accepting new patients
White Drug Co of Jamestown Inc PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1497181838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 6TH AVE NE",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580722347",
            "telephone_number": "701-430-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580723319",
            "telephone_number": "701-845-1763",
            "fax_number": "701-845-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "SAMANTHA",
        "middle_name": "JAYNE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH5596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley City, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.