Active NPI
Samuel James Determan, D.P.M.
- Foot Surgery Podiatrist
- Omaha, NE
National Provider Identifier
1548219462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 296
- Practice address
- 17816 Holmes Cir
Omaha, NE 68135-3406 - Phone
- (402) 895-2583
- NPI assigned
- May 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 296 | NE | Primary |
Addresses
Primary practice location
17816 Holmes Cir
Omaha, NE 68135-3406
Mailing address
17816 Holmes Cir
Omaha, NE 68135-3406
Phone (402) 895-2583
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
| License | State | Type | Specialty |
|---|---|---|---|
| 296 | NE | MD | Foot Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548219462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17816 HOLMES CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681353406",
"telephone_number": "402-895-2583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17816 HOLMES CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681353406",
"telephone_number": "402-895-2583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETERMAN",
"first_name": "SAMUEL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NE",
"license": "296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.