Caroline E Sam

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1106805 Issued in TX

Practice address

4215 Gannon LN
Dallas, TX 75237-2914

Phone

(972) 283-9090

Fax

(972) 499-0367

NPI assigned

Dec 19, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Faith Behavioral Health PLLC

  • Child & Adolescent Psychiatry Physician
  • Frisco, TX
  • NPI 1639705130
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health, TX

  Medicare reassignment NPD
• Care Dominance Healthcare Service LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Celina, TX
  • NPI 1023704764
  NPD Authorized official

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1932507274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 AIRPORT EXECUTIVE BOULEVARD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "10958",
            "telephone_number": "845-425-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 GANNON LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372914",
            "telephone_number": "972-283-9090",
            "fax_number": "972-499-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "CAROLINE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1106805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvus Anesthesia, PLLC
• Lynn A Salzberger
• Sam Seunghae Ahn, MD,PA
• Sam T. Hamra M.D. P. a.
• Blessy Sam, MSN, APRN, FNP-C
• Leroy Sam, ATC, LAT, LMT
• Maurine Sam
• Stephany Sam
• Teena Sam, PHARMD
• Sam'S Club Optical

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.

Verify at the official NPI Registry.