Active NPI
Samantha Jayne Walas
- Home Health Registered Nurse
- Medford, MA
National Provider Identifier
1821557422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- RN2309155
- Practice address
- 151 Jerome St
Medford, MA 02155-3534 - Phone
- (413) 218-1043
- NPI assigned
- Mar 14, 2019
- 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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | RN2309155 | MA | Primary |
Addresses
Primary practice location
151 Jerome St
Medford, MA 02155-3534
Mailing address
16 Sanborn Ave
West Roxbury, MA 02132-3818
Phone (617) 218-1043
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 |
|---|---|---|---|
| RN2309155 | MA | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552521600000",
"number": "1821557422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 SANBORN AVE",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021323818",
"telephone_number": "617-218-1043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 JEROME ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553534",
"telephone_number": "413-218-1043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALAS",
"first_name": "SAMANTHA",
"middle_name": "JAYNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-14",
"last_updated": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "MA",
"license": "RN2309155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.