MR. SAMMIE III O'NEAL (MA, CDC1) – Counselor, NPI 1053784314

MR. SAMMIE III O'NEAL (MA, CDC1) is a healthcare provider. based in Greenville, Texas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, CDC1. The NPI Number for MR. SAMMIE III O'NEAL (MA, CDC1) is 1053784314

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
MR. SAMMIE III O'NEAL (MA, CDC1)
NPI
1053784314
Phone
(907) 406-3033
Address
2830 MALLARD DR
Enumeration Date
9 November 2015
Last Update Date
24 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9074063033
Graduation Year
2018 (8 years ago)
PAC ID
2062853682
Professional Enrollment ID
I20240514003124
Address ID
AK99577XXXXEAXXXXXXXXXX00
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:10State licenses:0Digital endpointsOther names

230 MENTAL HEALTH COUNSELOR in AK

Provider Addresses for MR. SAMMIE III O'NEAL (MA, CDC1)

  • 2830 MALLARD DR

    GREENVILLE, TX 754024131

    Phone: (907) 406-3033

    Type: Mailing

  • 20442 PTARMIGAN BLVD

    EAGLE RIVER, AK 995778735

    Phone: (907) 406-3033

    Type: Location

  • 2600 CORDOVA ST STE 101

    ANCHORAGE, AK 995032745

    Phone: (907) 279-9627

    Type: Mailing

  • 8012 STEWART MOUNTAIN DR

    EAGLE RIVER, AK 995779013

    Phone: (907) 689-1530

    Type: Location

  • 12518 CRESTED BUTTE DRIVE

    EAGLE RIVER, AK 995772745

    Phone: (907) 406-3033

    Type: Mailing

  • 12518 CRESTED BUTTE DR

    EAGLE RIVER, AK 995777654

    Phone: (907) 406-3033

    Type: Location

  • 2600 Cordova St Ste 101

    Anchorage, AK 995032745

    Phone: (907) 279-9627

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240514003124IMental Health CounselorAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75402)

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Reviews

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Frequently asked questions

How is MR. SAMMIE III O'NEAL (MA, CDC1) identified in CMS data?
CMS-hosted NPPES data lists MR. SAMMIE III O'NEAL (MA, CDC1) with NPI 1053784314.
Does CMS list MR. SAMMIE III O'NEAL (MA, CDC1) as active?
Yes — MR. SAMMIE III O'NEAL (MA, CDC1) is active in the NPI listing used on this page.
What taxonomy line describes MR. SAMMIE III O'NEAL (MA, CDC1)?
For research purposes, treat MR. SAMMIE III O'NEAL (MA, CDC1) as Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MR. SAMMIE III O'NEAL (MA, CDC1)?
MR. SAMMIE III O'NEAL (MA, CDC1)'s geographic hint is Greenville, Texas in our summary view.
Why does MR. SAMMIE III O'NEAL (MA, CDC1) have multiple addresses?
7 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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