NPIMap

Organization Active NPI

Samson K Orusa PC

  • Primary Care Clinic/Center
  • Clarksville, TN
National Provider Identifier
1770715013
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
28275 Issued in TN
Legal business name
SAMSON K ORUSA PC
Practice address
261 Stonecrossing Dr
Clarksville, TN 37042-8404
Phone
(931) 906-4366
Fax
(931) 906-4365
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Dr. Samson Kanla Orusa, M.DNPI 1346388568
Title
President.
Phone
(931) 906-4366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 28275 TN Primary
Pain Clinic/Center 261QP3300X 28275 TN

Addresses

Primary practice location

261 Stonecrossing Dr
Clarksville, TN 37042-8404

Mailing address

261 Stonecrossing Dr
Clarksville, TN 37042-8404
Phone (931) 906-4366

National Provider Directory

National Provider Directory

Locations

261 Stonecrossing Dr
Clarksville, TN 37042
Phone (931) 906-4366

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1770715013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 STONECROSSING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370428404",
            "telephone_number": "931-906-4366",
            "fax_number": "931-906-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 STONECROSSING DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370428404",
            "telephone_number": "931-906-4366",
            "fax_number": "931-906-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMSON K ORUSA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "ORUSA",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_middle_name": "KANLA",
        "authorized_official_title_or_position": "PRESIDENT.",
        "authorized_official_telephone_number": "931-906-4366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "28275",
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "TN",
            "license": "28275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.