Individual provider Active NPI

Sampson McSidney

  • Case Management Agency
  • Oklahoma City, OK
National Provider Identifier
1689923856
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
14717 Hollyhock Dr
Oklahoma City, OK 73142
Phone
(405) 414-0091
NPI assigned
Sep 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

14717 Hollyhock Dr
Oklahoma City, OK 73142

Mailing address

14717 Hollyhock Dr
Oklahoma City, OK 73142
Phone (405) 414-0091

Other identifiers 1

IdentifierTypeStateIssuer
100719930AMedicaidOK

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

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1689923856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14717 HOLLYHOCK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73142",
            "telephone_number": "405-414-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14717 HOLLYHOCK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73142",
            "telephone_number": "405-414-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSIDNEY",
        "first_name": "SAMPSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100719930A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.