Active NPI
Kelly-Lee Samantha Samuels
- Licensed Practical Nurse
- Bronx, NY
National Provider Identifier
1568768463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 304815
- Practice address
- 140 Asch Loop
Bronx, NY 10475-4033 - Phone
- (347) 595-7519
- NPI assigned
- Feb 10, 2011
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 304815 | NY | Primary |
Addresses
Primary practice location
140 Asch Loop
Bronx, NY 10475-4033
Mailing address
140 Asch Loop
Bronx, NY 10475-4033
Phone (347) 595-7519
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
| License | State | Type | Specialty |
|---|---|---|---|
| 304815 | NY | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297468800000",
"number": "1568768463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 ASCH LOOP",
"city": "BRONX",
"state": "NY",
"postal_code": "104754033",
"telephone_number": "347-595-7519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 ASCH LOOP",
"city": "BRONX",
"state": "NY",
"postal_code": "104754033",
"telephone_number": "347-595-7519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "KELLY-LEE",
"middle_name": "SAMANTHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-10",
"last_updated": "2011-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "304815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.