Active NPI
Diane E Sampson, MD
- Pediatrics Physician
- Suffolk, VA
National Provider Identifier
1720316185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101039174
- Practice address
- 4868 Bridge Rd
Suffolk, VA 23435-2048 - Phone
- (757) 483-7113
- Fax
- (757) 483-7151
- NPI assigned
- Nov 24, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101039174 | VA | Primary |
Addresses
Primary practice location
4868 Bridge Rd
Suffolk, VA 23435-2048
Mailing address
2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 539-0251
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101039174 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1720316185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 MEADE PKWY",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234344259",
"telephone_number": "757-539-0251",
"fax_number": "757-934-9497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4868 BRIDGE RD",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234352048",
"telephone_number": "757-483-7113",
"fax_number": "757-483-7151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "DIANE",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-24",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101039174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.