Individual provider Active NPI

Samantha Camille Ricks, PHARMD, BCPP

  • Pharmacist
  • Decatur, GA
National Provider Identifier
1629699699
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH030503 Issued in GA
Practice address
2641 E College Ave Apt 736
Decatur, GA 30030-3380
Phone
(773) 957-3903
NPI assigned
Apr 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19846 AL
Pharmacist 183500000X 26025426A IN
Pharmacist 183500000X 051290197 IL
Pharmacist 183500000X RPH030503 GA Primary

Addresses

Primary practice location

2641 E College Ave Apt 736
Decatur, GA 30030-3380

Mailing address

2641 E College Ave Apt 736
Decatur, GA 30030-3380
Phone (773) 957-3903

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19846ALMDPharmacist
RPH030503GAMDPharmacist
051290197ILMDPharmacist
26025426AINMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1629699699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 E COLLEGE AVE APT 736",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303380",
            "telephone_number": "773-957-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 E COLLEGE AVE APT 736",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303380",
            "telephone_number": "773-957-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "SAMANTHA",
        "middle_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "19846",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26025426A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051290197",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH030503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.