Samantha Marie Neely, MSN, RN, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704311141 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 936-4000

NPI assigned

Dec 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Zajac Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Regents of the University of Michigan

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1205868353
  Medicare reassignment NPD
• Regents of the University of Michigan

  • Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1447275102
  Medicare reassignment NPD
• Regents of the University of Michigan

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ann Arbor, MI
  • NPI 1487689766

  Nurse Practitioner

  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1013504133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "468 Cadieux Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301507",
            "country_code": "US",
            "telephone_number": "313-473-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEELY",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704311141",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704311141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ZAJAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vandya Nedle
• Karen A Neeb, CNP
• Pauline Wing Neeb, NP
• Jessica Needham
• Adriene T Neely, LPN
• Andrew James Neevel, MD
• Adrianne Marie Neff, PA-C
• Mary P Neff, CRNA
• Judy Negele, M.D.
• Selene Negrette

• Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.