Samuel Dallas McComber, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95146216 Issued in CA

Practice address

785 18TH St
Arcata, CA 95521-5683

Phone

(707) 822-2481

Fax

(707) 822-3656

NPI assigned

Nov 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sam Dallas McComber Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1962916502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST STE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 18TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215683",
            "telephone_number": "707-822-2481",
            "fax_number": "707-822-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMBER",
        "first_name": "SAMUEL",
        "middle_name": "DALLAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95146216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "MCCOMBER",
            "middle_name": "DALLAS",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• MCC Medical, LLC
• Elizabeth McCallion, PHD
• Carly McCameron, DPT
• Anna McClure
• Dylan McClure
• Miranda McConnell-Kamaal
• Texas Joshua McCue-Green, RN
• Lynda Ann McDevitt, M.S.,L.AC.
• Cocome M McKamey
• Shane Matthew McKay

• Registered Nurse in Arcata, CA
• Providers in Arcata, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.