Individual provider Active NPI

Samjhana Thapa

  • Family Nurse Practitioner
  • Twentynine Palms, CA
National Provider Identifier
1023870003
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4015509 Issued in KY
Practice address
74455 Joe Davis Dr Apt 104
Twentynine Palms, CA 92277-2384
Phone
(618) 203-3133
NPI assigned
Jan 25, 2024
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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 4015509 KY Primary

Addresses

Primary practice location

74455 Joe Davis Dr Apt 104
Twentynine Palms, CA 92277-2384

Mailing address

74455 Joe Davis Dr Apt 104
Twentynine Palms, CA 92277-2384
Phone (618) 203-3133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240216002929 KY Practitioner - Nurse Practitioner 0840634986 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Primary Care PLLC Multi-Specialty CurrentSince Mar 1, 2024 Accepting new patients
Healthy Living Primary Care Multi-Specialty CurrentSince Feb 1, 2024 Accepting new patients

Locations

6520 W Highway 22
Crestwood, KY 40014
Phone (502) 241-8488

4400 Breckenridge Ln
Ste 147
Louisville, KY 40218
Phone (502) 708-1904

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1023870003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74455 JOE DAVIS DR APT 104",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772384",
            "telephone_number": "618-203-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74455 JOE DAVIS DR APT 104",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772384",
            "telephone_number": "618-203-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAPA",
        "first_name": "SAMJHANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4015509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

Verify at the official NPI Registry.