Individual provider Active NPI

Megan Patricia Samples

  • Clinical Neuropsychologist
  • Watervliet, MI
National Provider Identifier
1043612724
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301019159 Issued in MI
Practice address
400 Medical Park Dr
Watervliet, MI 49098-9225
Phone
(269) 463-3600
NPI assigned
Sep 24, 2014
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6301019159 MI Primary
Psychologist 103T00000X 6301019159 MI
Clinical Psychologist 103TC0700X 6301019159 MI

Addresses

Primary practice location

400 Medical Park Dr
Watervliet, MI 49098-9225

Mailing address

400 Medical Park Dr
Watervliet, MI 49098-9225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110002105 MI Practitioner - Clinical Psychologist 1557738119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 463-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301019159MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Pathology Assoc of Southwestern Michigan, PC Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Sep 12, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Sep 12, 2022 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Sep 12, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Sep 12, 2022 Accepting new patients

Locations

7040 Red Arrow Hwy
Coloma, MI 49038
Phone (269) 468-4318

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
  • Direct secure messaging: msamples267253@epic00.corewelldirect.org

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 1

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1043612724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-463-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "MEGAN",
        "middle_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301019159",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301019159",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watervliet, MI

Sources for this page

Verify at the official NPI Registry.