Individual provider Active NPI

Joseph Herman Sample, M.D.

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1881709376
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D4294 Issued in TX
Practice address
4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339
Phone
(972) 758-6000
Fax
(972) 758-6001
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D4294 TX Primary

Addresses

Primary practice location

4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339

Mailing address

4708 Alliance Blvd Ste 300
Baylor Medical Plaza 1
Plano, TX 75093-5339
Phone (972) 758-6000

Other identifiers 1

IdentifierTypeStateIssuer
83X012OtherTXBCBS

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1881709376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 300",
            "address_2": "BAYLOR MEDICAL PLAZA 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935339",
            "telephone_number": "972-758-6000",
            "fax_number": "972-758-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 300",
            "address_2": "BAYLOR MEDICAL PLAZA 1",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935339",
            "telephone_number": "972-758-6000",
            "fax_number": "972-758-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "JOSEPH",
        "middle_name": "HERMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D4294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83X012",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.