Active NPI
Samuel Drinnon Ross, DO
- Student in an Organized Health Care Education/Training Program
- Marietta, GA
National Provider Identifier
1841043189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 833 Campbell Hill St. NW
Suite 250
Marietta, GA 30060 - Phone
- (470) 956-2020
- Fax
- (770) 999-2785
- NPI assigned
- Apr 8, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
833 Campbell Hill St. NW
Suite 250
Marietta, GA 30060
Mailing address
677 Church St
Green Tower, Lower Level
Marietta, GA 30060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240712001152 | GA | Order and Referring Only - Internal Medicine | 9931644077 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1841043189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 CHURCH ST",
"address_2": "GREEN TOWER, LOWER LEVEL",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 CAMPBELL HILL ST. NW",
"address_2": "SUITE 250",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060",
"telephone_number": "470-956-2020",
"fax_number": "770-999-2785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "SAMUEL",
"middle_name": "DRINNON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-08",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.