Individual provider Active NPI

Samantha Marie Herman

  • Nurse Practitioner
  • Kingwood, TX
National Provider Identifier
1003477019
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
908296 Issued in TX
Practice address
22710 Professional Dr Ste 203
Kingwood, TX 77339-6009
Phone
(281) 312-8530
Fax
(281) 719-5916
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 908296 TX Primary

Addresses

Primary practice location

22710 Professional Dr Ste 203
Kingwood, TX 77339-6009

Mailing address

22710 Professional Dr Ste 102
Kingwood, TX 77339-6009
Phone (281) 312-8530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427002820 TX Practitioner - Nurse Practitioner 0345658563 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
908296TXMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: samantha.hermanfnpc.p1@direct.mphcc.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1003477019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22710 PROFESSIONAL DR STE 102",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773396009",
            "telephone_number": "281-312-8530",
            "fax_number": "281-719-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22710 PROFESSIONAL DR STE 203",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773396009",
            "telephone_number": "281-312-8530",
            "fax_number": "281-719-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "908296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.