Active NPI
Samantha Mae Chan, PHARMD
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1548787393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19648
- Practice address
- 9420 W Lake Mead Blvd
Las Vegas, NV 89134-8312 - Phone
- (702) 363-5247
- NPI assigned
- Aug 23, 2017
- Last updated
- Jan 20, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19648 | NV | Primary |
Addresses
Primary practice location
9420 W Lake Mead Blvd
Las Vegas, NV 89134-8312
Mailing address
9420 W Lake Mead Blvd
Las Vegas, NV 89134-8312
Other practice location 1
11001 S Eastern Ave
Henderson, NV 89052-2954
Phone (702) 948-8355
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1548787393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9420 W LAKE MEAD BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891348312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9420 W LAKE MEAD BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891348312",
"telephone_number": "702-363-5247"
}
],
"practiceLocations": [
{
"address_1": "11001 S Eastern Ave",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NV",
"postal_code": "890522954",
"country_code": "US",
"telephone_number": "702-948-8355",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAN",
"first_name": "SAMANTHA",
"middle_name": "MAE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "19648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.