Active NPI
Samantha Adelle Gilmore
- Addiction (Substance Use Disorder) Counselor
- Alliance, NE
National Provider Identifier
1770968414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- P-1338
- Practice address
- 815 Flack Ave
Alliance, NE 69301-2722 - Phone
- (308) 762-2723
- Fax
- (308) 217-4277
- NPI assigned
- Jul 23, 2015
- Last updated
- Jul 23, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | P-1338 | NE | Primary |
Addresses
Primary practice location
815 Flack Ave
Alliance, NE 69301-2722
Mailing address
815 Flack Ave
Alliance, NE 69301-2722
Phone (308) 762-2723
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 |
|---|---|---|---|
| P-1338 | NE | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1770968414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 FLACK AVE",
"city": "ALLIANCE",
"state": "NE",
"postal_code": "693012722",
"telephone_number": "308-762-2723",
"fax_number": "308-217-4277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 FLACK AVE",
"city": "ALLIANCE",
"state": "NE",
"postal_code": "693012722",
"telephone_number": "308-762-2723",
"fax_number": "308-217-4277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "SAMANTHA",
"middle_name": "ADELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "P-1338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alliance, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.