NPIMap

Individual provider Active NPI

Samantha Joanne Justice, NP

  • Family Nurse Practitioner
  • Tishomingo, MS
National Provider Identifier
1013267152
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R874488 Issued in MS
Practice address
1310 Main Street
Tishomingo, MS 38873-3887
Phone
(662) 471-9416
Fax
(662) 438-7760
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Primary Health Care Inc 27 clinicians

Practice addresses (Care Compare)

15921 Boundary Dr
Ashland, MS 38603-7740
Phone (662) 224-8951

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Tupelo, MS, CCN 257303
  • North Mississippi Medical Ctr HHA Home health agency, Tupelo, MS, CCN 257002
  • Tishomingo Health Services Inc Hospital, Iuka, MS, CCN 250002
  • Red Bay Hospital Hospital, Red Bay, AL, CCN 011302
  • Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130211000312 MS Practitioner - Nurse Practitioner 5092969501 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R874488MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Primary Health Care, Inc. Current Accepting new patients
North Mississippi Primary Health Care, Inc. CurrentSince Mar 25, 2013 Accepting new patients
North Mississippi Primary Health Care, Inc. CurrentSince Mar 25, 2013 Accepting new patients
Landmark Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
North Mississippi Primary Health Care, Inc. PastSince Jun 18, 2023 Accepting new patients

Locations

1415 S Harper Rd
Corinth, MS 38834
Phone 6622248951299

7615 Clarington Cv
Southaven, MS 38671
Phone (662) 536-2500

Interoperability endpoints

  • Direct secure messaging: samantha.justice.1@28179.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIHAA

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R874488 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

1310 Main Street
Tishomingo, MS 38873-3887

Mailing address

PO Box 92
Ashland, MS 38603-0092
Phone (662) 224-8951

Other practice location 1

1415 S Harper Rd
Corinth, MS 38834-6613
Phone (662) 396-4406

Other practice location 2

3114 E Shiloh Rd
Corinth, MS 38834-2909
Phone (662) 396-4406

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2023.

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013267152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92",
            "city": "ASHLAND",
            "state": "MS",
            "postal_code": "386030092",
            "telephone_number": "662-224-8951",
            "fax_number": "662-224-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MAIN STREET",
            "city": "TISHOMINGO",
            "state": "MS",
            "postal_code": "388733887",
            "telephone_number": "662-471-9416",
            "fax_number": "662-438-7760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 S Harper Rd",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388346613",
            "country_code": "US",
            "telephone_number": "662-396-4406",
            "fax_number": "662-396-4482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3114 E Shiloh Rd",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388342909",
            "country_code": "US",
            "telephone_number": "662-396-4406",
            "fax_number": "662-396-4482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "SAMANTHA",
        "middle_name": "JOANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R874488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, MS

Sources for this page

Verify at the official NPI Registry.