Individual provider Active NPI

Samuel W Flannagan, MD

  • Gynecology Physician
  • Latrobe, PA
National Provider Identifier
1598751067
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD010947E Issued in PA
Practice address
212 W 2ND Ave
Latrobe, PA 15650-1069
Phone
(724) 537-1870
Fax
(724) 532-6975
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD010947E PA Primary

Addresses

Primary practice location

212 W 2ND Ave
Latrobe, PA 15650-1069

Mailing address

212 W 2ND Ave
Latrobe, PA 15650-1069
Phone (724) 537-1870

Other identifiers 1

IdentifierTypeStateIssuer
0006682700010MedicaidPA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD010947EPAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OBGYN Inc CurrentSince Apr 30, 2007 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

217 Depot St
Latrobe, PA 15650
Phone (724) 539-3595

911 Ligonier St
Ste 205
Latrobe, PA 15650
Phone (724) 532-2322

Interoperability endpoints

  • Direct secure messaging: sflannagan@direct.excelahealth.org

Organizations & group practices 2

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1598751067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W 2ND AVE",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501069",
            "telephone_number": "724-537-1870",
            "fax_number": "724-532-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 2ND AVE",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501069",
            "telephone_number": "724-537-1870",
            "fax_number": "724-532-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNAGAN",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PA",
            "license": "MD010947E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006682700010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.