Samuel O Battle
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Tampa, FL
NPI 1013635150 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1013635150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN9356493 (FL)
- Practice address
- 4300 West Cypress
Tampa, FL 33607-4159 - Phone
- (813) 207-7769
- Fax
- (813) 200-2080
- NPI assigned
- Aug 15, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lifestream Behavioral Center Inc
Practice addresses (Care Compare)
2018 Tally Rd
Leesburg, FL 34748-3426
Phone (352) 315-7400
2020 Tally Rd
Leesburg, FL 34748-3426
Phone (352) 315-7800
215 N 3Rd St
Leesburg, FL 34748-5105
Phone (352) 315-7900
3238 S Lecanto Hwy
Lecanto, FL 34461-9025
Phone (352) 632-4500
3264 S Lecanto Hwy
Lecanto, FL 34461-9025
Phone (352) 632-4500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221116000120 | FL | Practitioner - Nurse Practitioner | 9436527835 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN9356493 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifestream Behavioral Center Inc | Current |
Accepting new patients | |
| Lifestream Behavioral Center Inc | Current |
Accepting new patients | |
| Family Care Center, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Family Care Center, LLC | Current |
Accepting new patients |
Locations
215 N 3rd St
Leesburg, FL 34748
Phone (352) 315-7900
4300 W Cypress St
Ste 825
Tampa, FL 33607
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN9356493 | FL | Yes |
Addresses
Primary practice location
4300 West Cypress
Tampa, FL 33607-4159
Mailing address
4300 West Cypress
Tampa, FL 33607-4159
Phone (813) 207-7769
Other practice location 1
6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone (855) 232-0644
Other providers in Tampa, FL
- Mary Battershell
- Erkan Batti
- Claudia Irene Battistini
- Breyata Janese Battle
- Diane Battle
- Kasey Erikamarie Battles
- Taneisha L Battles
- Taylor Hoke Baudier
- Greg Stephen Bauer
- Hannah Jane Bauer
All providers in Tampa, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.