DR. SHOJI OLIVO SAMSON DO NPI 1831504067

NPI Information

NPI: 1831504067
Provider Name: DR. SHOJI OLIVO SAMSON, DO
Classification: Pediatrics - 2080N0001X
Entity Type: Individual

Specialization: Neonatal-Perinatal Medicine

PECOS Registration: Yes

Address:
530 NS GLEN OAK AVENUE
PEORIA, IL
ZIP 61637
Phone: (309) 624-2896
Get Directions

DR. Shoji Olivo Samson, DO is a neonatal-perinatal medicine pediatrics in Peoria, IL. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. DR. Shoji Olivo Samson, DO NPI is 1831504067. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

530 NS GLEN OAK AVENUE
PEORIA, IL
ZIP 61637-001
Phone: (309) 624-2896
Fax: (309) 655-2974

The NPI 1831504067 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2014 and was last updated on 1/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		S0375	TEXAS	No
2	208000000X	Pediatrics		DO-05910	IOWA	No
3	208000000X	Pediatrics		288816	NEW YORK	No
4	208000000X	Pediatrics		036152483	ILLINOIS	No
5	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	DO-05910	IOWA	No
6	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	288816	NEW YORK	No
7	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	S0375	TEXAS	No
8	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	036152483	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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