Individual provider Active NPI

Samantha Ann Stewart

  • Family Nurse Practitioner
  • Covington, KY
National Provider Identifier
1063826840
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016307 Issued in KY
Practice address
205 Pike St
Covington, KY 41011-2321
Phone
(901) 482-9567
NPI assigned
Jun 19, 2014
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3016307 KY Primary
Family Nurse Practitioner 363LF0000X 18794 TN
Family Nurse Practitioner 363LF0000X 0031132 OH

Addresses

Primary practice location

205 Pike St
Covington, KY 41011-2321

Mailing address

3546 Linwood Ave
Cincinnati, OH 45226-1402
Phone (901) 482-9567

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523001546 MI Practitioner - Nurse Practitioner 7315168424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onsight IncGroup PAC ID 6507938800, 27 clinicians

Practice addresses (Care Compare)

601 Abbot Rd
East Lansing, MI 48823-3366
Phone 24852821166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3016307KYMDFamily Nurse Practitioner
0031132OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Onsight, Inc. CurrentSince May 31, 2024 Accepting new patients
Vpa PC CurrentSince Jun 15, 2023 Accepting new patients
Vpa PC CurrentSince Jun 15, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Onsight, Inc. CurrentSince May 31, 2024 Accepting new patients
Onsight, Inc. Current Accepting new patients
Giaimo Mobile Podiatry of WV PLLC Past Accepting new patients

Locations

2567 W Grand Blvd
Detroit, MI 48208
Phone (313) 895-2990

601 Abbott Rd
East Lansing, MI 48823
Phone 24852821166

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Organizations & group practices 7

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1063826840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 LINWOOD AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452261402",
            "telephone_number": "901-482-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PIKE ST",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410112321",
            "telephone_number": "901-482-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016307",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18794",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0031132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.