Individual provider Active NPI

Samantha Anderson

  • Registered Nurse
  • Mount Vernon, NY
National Provider Identifier
1669860862
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
691976 Issued in NY
Practice address
9 W Prospect Ave
Suite 310
Mount Vernon, NY 10550-2018
Phone
(914) 699-0022
Fax
(914) 699-2154
NPI assigned
Dec 23, 2014
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 691976 NY Primary

Addresses

Primary practice location

9 W Prospect Ave
Suite 310
Mount Vernon, NY 10550-2018

Mailing address

113 Morris St
Apt 3
Yonkers, NY 10705-1887
Phone (347) 957-1840

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

LicenseStateTypeSpecialty
691976NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Home Health Care Inc Past Accepting new patients
Absolute Home Health Care Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1669860862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MORRIS ST",
            "address_2": "APT 3",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107051887",
            "telephone_number": "347-957-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 W PROSPECT AVE",
            "address_2": "SUITE 310",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502018",
            "telephone_number": "914-699-0022",
            "fax_number": "914-699-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "691976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.