OM SAM MD
NPI 1457845588
Family Medicine in Sullivan, MO

Q: What is Om Sam's NPI number?

The NPI number for Om Sam is 1457845588. It was assigned to this individual provider in the NPPES registry on June 21, 2018.

Q: What is Om Sam's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Om Sam was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 21, 2018

965 MATTOX DR, SULLIVAN, MO 63080(573) 860-6000 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 29, 2021, Jun 21, 2018 (2 updates tracked since 2018).

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About Om Sam Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OM SAM MD (NPI 1457845588) is an individual family medicine provider in Sullivan, Missouri, licensed in Missouri (2021026443) and active in the NPI registry since June 2018. He maintains a secondary practice location in Johnson City.

NPPES Registry Identity

NPI1457845588

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameOM SAMCredential: MD

Location Address965 MATTOX DRSullivan, MO 63080-2365

Mailing Address965 Mattox DrSullivan, MO 63080-2365 · (573) 860-6000

Phone(573) 860-6000

Sole ProprietorNo

Enumeration DateJune 21, 2018

Last NPPES UpdateJuly 29, 20212 updates tracked since enumeration

NPPES CertifiedJuly 29, 2021

✔ NPI 1457845588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2021026443

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

965 MATTOX DR, Sullivan, MO 63080

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Secondary Practice Location 1

Location 1507 Main StJohnson City, NY 13790-1810 · Phone (607) 763-6075

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL SALTZMAN

Dietitian, Registered