Active NPI
Samuel Saunders
- Intellectual & Developmental Disabilities Psychologist
- Cleveland, OH
National Provider Identifier
1871999417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- Practice address
- 16715 Palda Dr
Cleveland, OH 44128-3326 - Phone
- (239) 491-4636
- NPI assigned
- Nov 10, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | Primary |
Addresses
Primary practice location
16715 Palda Dr
Cleveland, OH 44128-3326
Mailing address
16715 Palda Drive
Cleveland, OH 44128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871999417 | Medicaid | OH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1871999417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16715 PALDA DRIVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16715 PALDA DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441283326",
"telephone_number": "239-491-4636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAUNDERS",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-10",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871999417",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.