Active NPI
Mary D Sampson, BACHELORS IN SOCIAL
- Case Manager/Care Coordinator
- Alexandria, LA
National Provider Identifier
1629602990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 15789
- Practice address
- 710 Versailles Blvd
Alexandria, LA 71303-2351 - Phone
- (318) 449-4474
- Fax
- (318) 449-4472
- NPI assigned
- Feb 26, 2020
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 15789 | LA | Primary |
Addresses
Primary practice location
710 Versailles Blvd
Alexandria, LA 71303-2351
Mailing address
710 Versailles Blvd
Alexandria, LA 71303-2351
Phone (318) 787-6749
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 |
|---|---|---|---|
| 15789 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1629602990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 VERSAILLES BLVD",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713032351",
"telephone_number": "318-787-6749",
"fax_number": "318-787-6804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 VERSAILLES BLVD",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713032351",
"telephone_number": "318-449-4474",
"fax_number": "318-449-4472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "MARY",
"middle_name": "D",
"credential": "BACHELORS IN SOCIAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-26",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "15789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.