Jonmichael Samsel, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

6253 Issued in TN

Practice address

2300 W Stone Dr
Kingsport, TN 37660-2360

Phone

(423) 246-4961

Fax

(423) 245-3136

NPI assigned

Mar 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates, P.C.Group PAC ID 3971578816, 26 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• TN PPO C-SNP
• MS PPO D-SNP
• MS PPO
• AL HMO D-SNP
• AL HMO
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• KY PPO
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• MS PPO C-SNP
• TN PPO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• KY PPO C-SNP

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.

• Dermatology Associates, P.C.

  • Dermatology Physician
  • Kingsport, TN
  • NPI 1487695862
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1003492653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2885 Boones Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376158002",
            "country_code": "US",
            "telephone_number": "423-928-9014",
            "fax_number": "423-245-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSEL",
        "first_name": "JONMICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102207529",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "6253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam W. Huddleston IV MD PC
• Sam'S Club Optical
• Ashley Samaniego, PMHNP-BC
• Stacey L Sampson
• Elijah Todd Samsel, FNP
• B Jeffrey Sanders, MD
• Holly A Sanders, MD
• Kathy Sellers Sanders, D.M.D.
• Nicholas B Sanders, PTA
• Sandgala, LLC

• Dermatology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.