Individual provider Active NPI

Samantha Grider

  • Family Nurse Practitioner
  • Columbus, IN
National Provider Identifier
1013303569
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28198183A Issued in IN
Practice address
2325 18TH St Ste 220
Columbus, IN 47201-5389
Phone
(812) 376-5640
NPI assigned
Apr 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28198183A IN Primary

Addresses

Primary practice location

2325 18TH St Ste 220
Columbus, IN 47201-5389

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgrider42464@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150929002198 IN Practitioner - Nurse Practitioner 6709194475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbus Regional Health Physicians LLCGroup PAC ID 1052612314, 216 clinicians

Practice addresses (Care Compare)

2325 18TH St
Suite 220
Columbus, IN 47201-5389
Phone (812) 376-5640

Hospital & facility affiliations

  • Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28198183AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Jan 1, 2023 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Jan 1, 2023 Accepting new patients
Southern Indiana Surgery Inc CurrentSince Jan 8, 2018 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Regional Health Physicians, LLC Past Accepting new patients

Locations

2325 18th St
Ste 220
Columbus, IN 47201
Phone (812) 372-2245

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

2109 Doctors Park Dr
Columbus, IN 47203
Phone (812) 348-4080

Interoperability endpoints

  • Direct secure messaging: sgrider42464@edirect.crh.org
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70317

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1428710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1013303569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 18TH ST STE 220",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015389",
            "telephone_number": "812-376-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-11",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28198183A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgrider42464@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "2325 18th St Ste 220",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.