Individual provider Active NPI

Angela L Sams, NP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1013392620
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71005836A Issued in IN
Practice address
4498 1St Ave
Evansville, IN 47710-3622
Phone
(812) 436-7280
Fax
(812) 436-7290
NPI assigned
Jul 24, 2015
Last updated
Oct 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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 71005836A IN Primary

Addresses

Primary practice location

4498 1St Ave
Evansville, IN 47710-3622

Mailing address

PO Box 3407
Evansville, IN 47733-3407
Phone (812) 436-7280

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
I20151019000447 IN Practitioner - Nurse Practitioner 2062721863 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
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71005836AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Dec 1, 2018 Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner Current Accepting new patients
Deaconess Hospital Inc Nurse Practitioner CurrentSince Oct 6, 2015 Accepting new patients
Deaconess Clinic Inc. Nurse Practitioner CurrentSince Dec 1, 2018 Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner CurrentSince Oct 6, 2015 Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Past Accepting new patients

Locations

120 SE 4th St
Evansville, IN 47708
Phone (812) 426-6638

1750 Oak Hill Rd
Evansville, IN 47711
Phone (812) 479-1777

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4498 N 1st Ave
Evansville, IN 47710
Phone (812) 436-7280

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1013392620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-436-7280",
            "fax_number": "812-436-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4498 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103622",
            "telephone_number": "812-436-7280",
            "fax_number": "812-436-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005836A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.