Active NPI
Samantha Lauren Davis
- Peer Specialist
- Canton, OH
National Provider Identifier
1598515371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.004972
- Practice address
- 4111 Bradley Cir NW
Canton, OH 44718-2688 - Phone
- (330) 546-0199
- NPI assigned
- Mar 25, 2024
- Last updated
- Mar 25, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | APS.004972 | OH | Primary |
Addresses
Primary practice location
4111 Bradley Cir NW
Canton, OH 44718-2688
Mailing address
4111 Bradley Cir NW
Canton, OH 44718-2688
Phone (330) 546-0199
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 |
|---|---|---|---|
| APS.004972 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1598515371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 BRADLEY CIR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182688",
"telephone_number": "330-546-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 BRADLEY CIR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182688",
"telephone_number": "330-546-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SAMANTHA",
"middle_name": "LAUREN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.004972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.