Active NPI
Serita D Samuel, LPN
- Licensed Vocational Nurse
- Ft Hood, TX
National Provider Identifier
1699785378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 187388
- Practice address
- 58TH and 761St Tank Battallion Ave
Thomas Monre Health Clinic BLDG 2245
Ft Hood, TX 76544 - Phone
- (254) 288-2621
- NPI assigned
- Aug 8, 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 187388 | TX | Primary |
Addresses
Primary practice location
58TH and 761St Tank Battallion Ave
Thomas Monre Health Clinic BLDG 2245
Ft Hood, TX 76544
Mailing address
36000 Darnall Loop
Carl R Darnall Army Medical Center
Fort Hood, TX 76544
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
| License | State | Type | Specialty |
|---|---|---|---|
| 187388 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699785378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36000 DARNALL LOOP",
"address_2": "CARL R DARNALL ARMY MEDICAL CENTER",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58TH AND 761ST TANK BATTALLION AVE",
"address_2": "THOMAS MONRE HEALTH CLINIC BLDG 2245",
"city": "FT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-288-2621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SERITA",
"middle_name": "D",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "187388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.