La Sharon Bobo Samuels, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301070962 Issued in MI

Practice address

4986 N Adams Rd
Suite C
Rochester, MI 48306-5017

Phone

(248) 475-5601

NPI assigned

Jun 4, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11246/brand/1/csg/1/fhir/r4
• Direct secure messaging: lsamuels1150141@direct.hfhs.org
• Direct secure messaging: lasharon.samuels.1@11246.direct.athenahealth.com

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.

• Country Creek Pediatrics, PLLC

  • Pediatrics Physician
  • Rochester, MI
  • NPI 1194792168
  NPD (past)

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1760743009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MILL HOUSE DR",
            "city": "OAKLAND",
            "state": "MI",
            "postal_code": "483631611",
            "telephone_number": "313-506-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 N ADAMS RD",
            "address_2": "SUITE C",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483065017",
            "telephone_number": "248-475-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "LA SHARON",
        "middle_name": "BOBO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301070962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beza T Sahlie, MD
• Pakhal Saketha
• Tanaz Salimnia, M.D.
• Dhairya Jigar Salvi, M.D.
• Blessen Samuel, PT
• Evan Sangster
• Delfin Santos, M.D.
• Amy Sartor, MA, CCC- SLP
• Patrizia Scalia, DDS
• Katharine A Scharer, MD

• Pediatrics Physician in Rochester, MI
• Providers in Rochester, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.