Active NPI
Samara Ellen Kester, DO
- Emergency Medicine Physician
- Valparaiso, IN
National Provider Identifier
1639280365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 02001380A
- Practice address
- 814 Laporte Ave
Valparaiso, IN 46383-5860 - Phone
- (219) 263-4600
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 02001380A | IN | Primary |
Addresses
Primary practice location
814 Laporte Ave
Valparaiso, IN 46383-5860
Mailing address
1155 W 3Rd St
Bloomington, IN 47404-5016
Phone (812) 336-1690
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100331070 | Medicaid | IN | |
| 02001380A | Other | IN | IN LICENSE |
| 000000615411 | Other | IN | BLUE CROSS BLUE SHIELD |
| 02001380B | Other | IN | CSR |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02001380A | IN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple City Emergency Physicians, LLP | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- La Porte, IN
- NPI 1275558942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1639280365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 W 3RD ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474045016",
"telephone_number": "812-336-1690",
"fax_number": "812-349-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 LAPORTE AVE",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463835860",
"telephone_number": "219-263-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESTER",
"first_name": "SAMARA",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2023-03-07",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "02001380A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100331070",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IN LICENSE",
"identifier": "02001380A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000615411",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSR",
"identifier": "02001380B",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.