Samuel L. Church, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

048990 Issued in GA

Legal business name

SAMUEL L. CHURCH, MD, PC

Practice address

85 Seasons Lane
Hiawassee, GA 30546

Phone

(706) 896-0505

Fax

(866) 796-2502

NPI assigned

Feb 21, 2007

Last updated

Feb 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel L Church, MDNPI 1053398149

Title

Owner

Phone

(706) 896-0505

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Leroy Church, MD

  • Family Medicine Physician
  • Hiawassee, GA
  • NPI 1053398149
  Medicare reassignment NPD Authorized official
• Alexander Jones, PA

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1346034246
  Medicare reassignment NPD
• Kayla Mashburn Akers

  • Family Medicine Physician
  • Hiawassee, GA
  • NPI 1659078145
  Medicare reassignment
• Julia Paolino Richardson, PA-C

  • Physician Assistant
  • Athens, GA
  • NPI 1780074039
  Medicare reassignment

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1023153244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1217",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "305461217",
            "telephone_number": "706-896-0505",
            "fax_number": "866-796-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEASONS LANE",
            "city": "HIAWASSEE",
            "state": "GA",
            "postal_code": "30546",
            "telephone_number": "706-896-0505",
            "fax_number": "866-796-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL L. CHURCH, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-896-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "048990",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "048990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000901271D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89066J3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Marie Rivers, FNP-C
• Steven Paul Roach, PHARM.D.
• William Robinson, PHARMD
• Daniel Rosenbaum, OTR/L
• Elizabeth Kimsey Rouse, SLP
• Tamara Marie Sandler, ATC
• Twila R Sellers
• Anita Shvarts, MD
• Danielle Oswald Silver
• Kilee Rayelle Smith, DO

• Family Medicine Physician in Hiawassee, GA
• Providers in Hiawassee, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.