Individual provider Active NPI

John M. Samms, M.D.

  • Family Medicine Physician
  • Gig Harbor, WA
National Provider Identifier
1821008772
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00016833 Issued in WA
Practice address
4700 Point Fosdick Dr NW
Suite 220
Gig Harbor, WA 98335-1706
Phone
(253) 851-5121
Fax
(253) 851-3059
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00016833 WA Primary

Addresses

Primary practice location

4700 Point Fosdick Dr NW
Suite 220
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr NW
Suite 220
Gig Harbor, WA 98335-1706
Phone (253) 851-5121

Other identifiers 1

IdentifierTypeStateIssuer
1670306MedicaidWA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00016833WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1821008772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 220",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-851-5121",
            "fax_number": "253-851-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 220",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-851-5121",
            "fax_number": "253-851-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMS",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00016833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1670306",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.