Individual provider Active NPI

Peter Samona

  • Pharmacist
  • Royal Oak, MI
National Provider Identifier
1548925282
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302413932 Issued in MI
Practice address
209 E 12 Mile Rd
Royal Oak, MI 48073-4114
Phone
(248) 548-6180
NPI assigned
Nov 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302413932 MI Primary

Addresses

Primary practice location

209 E 12 Mile Rd
Royal Oak, MI 48073-4114

Mailing address

41420 Allspice Dr
Sterling Heights, MI 48314-4014
Phone (586) 744-8452

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

State licenses

LicenseStateTypeSpecialty
5302413932MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodward Detroit CVS, L.L.C. PastSince Nov 16, 2021 Accepting new patients

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1548925282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41420 ALLSPICE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483144014",
            "telephone_number": "586-744-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E 12 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734114",
            "telephone_number": "248-548-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMONA",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.