Active NPI
Virginia Fonash Samhouri, CRNP
- Gerontology Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1932131950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- UP006861H
- Practice address
- 2137 Welsh Rd
Suite 1-C
Philadelphia, PA 19115-4963 - Phone
- (215) 969-3944
- Fax
- (215) 969-3886
- NPI assigned
- Jul 7, 2006
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | UP006861H | PA | Primary |
Addresses
Primary practice location
2137 Welsh Rd
Suite 1-C
Philadelphia, PA 19115-4963
Mailing address
1394 Tanglewood Dr
North Wales, PA 19454-3677
Phone (215) 699-8199
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01021194286 | Medicaid | PA | |
| 0000910336 | Other | PA | KHPE |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UP006861H | PA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932131950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1394 TANGLEWOOD DR",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "194543677",
"telephone_number": "215-699-8199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2137 WELSH RD",
"address_2": "SUITE 1-C",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191154963",
"telephone_number": "215-969-3944",
"fax_number": "215-969-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMHOURI",
"first_name": "VIRGINIA",
"middle_name": "FONASH",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "PA",
"license": "UP006861H",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01021194286",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KHPE",
"identifier": "0000910336",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.