Individual provider Active NPI

Matthew Sammons, PHARM D.

  • Pharmacist
  • Paintsville, KY
National Provider Identifier
1508156282
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
014184 Issued in KY
Practice address
716 Broadway St
Paintsville, KY 41240-1357
Phone
(606) 220-2553
Fax
(606) 220-2554
NPI assigned
Apr 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 014184 KY Primary

Addresses

Primary practice location

716 Broadway St
Paintsville, KY 41240-1357

Mailing address

246 Robin Hill Rd
Paintsville, KY 41240-9352
Phone (614) 370-7015

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
014184KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Wellness Center CurrentSince Mar 16, 2020 Accepting new patients

Locations

716 Broadway St
Paintsville, KY 41240
Phone (606) 220-2553

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": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1508156282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 ROBIN HILL RD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412409352",
            "telephone_number": "614-370-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROADWAY ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401357",
            "telephone_number": "606-220-2553",
            "fax_number": "606-220-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "MATTHEW",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "014184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paintsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.