Delores Marie Sam, M.T.

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

License

CNA018155 Issued in NV

Practice address

515 Shoshone Cir
Elko, NV 89801-5072

Phone

(775) 738-2252

Fax

(775) 738-4219

NPI assigned

Aug 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Delores Marie Pope Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1740474089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SHOSHONE CIR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898015072",
            "telephone_number": "775-738-2252",
            "fax_number": "775-738-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SHOSHONE CIR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898015072",
            "telephone_number": "775-738-2252",
            "fax_number": "775-738-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "DELORES",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "NV",
            "license": "CNA018155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELORES",
            "last_name": "POPE",
            "middle_name": "MARIE",
            "prefix": "MR.",
            "credential": "M.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Laboratory Director (Non-physician) in Elko, NV
• Providers in Elko, NV by specialty
• Clinical Laboratory Director (Non-physician) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.