SAMUEL GLADE EADDY DO - NPI 1639921075 - Student in an Organized Health Care Education/Training Program in Toledo, OH

Q: What is Samuel Eaddy's NPI number?

The NPI number for Samuel Eaddy is 1639921075. It was assigned to this individual provider in the NPPES registry on April 1, 2024.

Q: What is Samuel Eaddy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Eaddy was last updated on April 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Samuel Glade Eaddy Do NPPES

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

SAMUEL GLADE EADDY DO (NPI 1639921075) is an individual student in an organized health care education/training program in Toledo, Ohio and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639921075

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL GLADE EADDYCredential: DO

Location Address2409 CHERRY ST STE 10Toledo, OH 43608-2625

Mailing Address2409 Cherry St Ste 10Toledo, OH 43608-2625 · (419) 251-6784

Phone(419) 251-6784

Sole ProprietorNo

Enumeration DateApril 1, 2024

NPPES CertifiedApril 1, 2024

✔ NPI 1639921075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2409 CHERRY ST STE 10, Toledo, OH 43608

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Glade Eaddy Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.