Individual provider Active NPI

Sam G Totimeh

  • Registered Nurse First Assistant
  • Coon Rapids, MN
National Provider Identifier
1699301309
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
2469309 Issued in MN
Practice address
11299 Robinson Dr NW Apt 203
Coon Rapids, MN 55433-7473
Phone
(763) 898-9162
NPI assigned
Mar 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 2469309 MN Primary

Addresses

Primary practice location

11299 Robinson Dr NW Apt 203
Coon Rapids, MN 55433-7473

Mailing address

11325 Robinson Dr NW Apt 305
Coon Rapids, MN 55433-7430
Phone (763) 898-9162

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
2469309MNMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Home Health Care LLC Current Accepting new patients
Direct Home Care Services LLC Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1699301309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11325 ROBINSON DR NW APT 305",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554337430",
            "telephone_number": "763-898-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11299 ROBINSON DR NW APT 203",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554337473",
            "telephone_number": "763-898-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTIMEH",
        "first_name": "SAM",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-14",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MN",
            "license": "2469309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.