Individual provider Active NPI

Samuel Adam Amos, RADT

  • Addiction (Substance Use Disorder) Counselor
  • Visalia, CA
National Provider Identifier
1770142101
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1313150618 Issued in CA
Practice address
120 W School Ave
Visalia, CA 93291-4925
Phone
(559) 625-4100
Fax
(559) 625-1970
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1313150618 CA Primary

Addresses

Primary practice location

120 W School Ave
Visalia, CA 93291-4925

Mailing address

120 W School Ave
Visalia, CA 93291-4925
Phone (559) 625-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sam@cvrshome.org

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

LicenseStateTypeSpecialty
R1313150618CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Recovery Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1770142101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W SCHOOL AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914925",
            "telephone_number": "559-625-4100",
            "fax_number": "559-625-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W SCHOOL AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914925",
            "telephone_number": "559-625-4100",
            "fax_number": "559-625-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOS",
        "first_name": "SAMUEL",
        "middle_name": "ADAM",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1313150618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sam@cvrshome.org",
            "affiliation": "N",
            "address_1": "120 W School Ave",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932914925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.