Active NPI
Samantha Buckham, LPN
- Nursing Care Agency
- Brooklyn, NY
National Provider Identifier
1730577883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 318644-1
- Practice address
- 322 E 31St St
Apt C6
Brooklyn, NY 11226-7974 - Phone
- (352) 777-9469
- NPI assigned
- Dec 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 318644-1 | NY | Primary |
Addresses
Primary practice location
322 E 31St St
Apt C6
Brooklyn, NY 11226-7974
Mailing address
322 E 31St St
Apt C6
Brooklyn, NY 11226-7974
Phone (352) 777-9469
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 |
|---|---|---|---|
| 318644-1 | NY | MD | Nursing Care Agency |
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": "1419292800000",
"number": "1730577883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 E 31ST ST",
"address_2": "APT C6",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112267974",
"telephone_number": "352-777-9469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 E 31ST ST",
"address_2": "APT C6",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112267974",
"telephone_number": "352-777-9469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKHAM",
"first_name": "SAMANTHA",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-23",
"last_updated": "2014-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "NY",
"license": "318644-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.