Active NPI
Samantha Rachel Kane, PH.D.
- Clinical Psychologist
- Salisbury, MD
National Provider Identifier
1669601977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04391
- Practice address
- 2336 Goddard Pkwy
Salisbury, MD 21801-1126 - Phone
- (410) 334-6961
- Fax
- (410) 334-6960
- NPI assigned
- Jul 8, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 04391 | MD | Primary |
| Clinical Psychologist | 103TC0700X | 0810003436 | VA |
Addresses
Primary practice location
2336 Goddard Pkwy
Salisbury, MD 21801-1126
Mailing address
2336 Goddard Pkwy
Salisbury, MD 21801-1126
Phone (410) 334-6961
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 609550003 | Medicaid | MD | |
| 609550001 | Medicaid | MD | |
| 609550002 | Medicaid | MD |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04391 | MD | MD | Clinical Psychologist |
| 0810003436 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1669601977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 GODDARD PKWY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218011126",
"telephone_number": "410-334-6961",
"fax_number": "410-334-6960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2336 GODDARD PKWY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218011126",
"telephone_number": "410-334-6961",
"fax_number": "410-334-6960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANE",
"first_name": "SAMANTHA",
"middle_name": "RACHEL",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-08",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04391",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810003436",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "609550003",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "609550001",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "609550002",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.