Individual provider Active NPI

Leslie E. Samo, ARNP

  • Family Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1811138704
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1726622 Issued in FL
Practice address
2556 Enterprise Rd
Orange City, FL 32763-7939
Phone
(386) 456-0289
Fax
(389) 456-0376
NPI assigned
Mar 23, 2009
Last updated
Mar 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1726622 FL Primary

Addresses

Primary practice location

2556 Enterprise Rd
Orange City, FL 32763-7939

Mailing address

8 Cadillac Dr
Ste. 250
Brentwood, TN 37027-5087
Phone (615) 425-4200

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1726622FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1811138704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CADILLAC DR",
            "address_2": "STE. 250",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275087",
            "telephone_number": "615-425-4200",
            "fax_number": "615-425-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 ENTERPRISE RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637939",
            "telephone_number": "386-456-0289",
            "fax_number": "389-456-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMO",
        "first_name": "LESLIE",
        "middle_name": "E.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "1726622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.