Samantha Quillen, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

16577 Issued in OH

Practice address

110 Dublin Dr
Dover, OH 44622-7805

Phone

(330) 343-0753

NPI assigned

Oct 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union Hospital Hospital, Dover, OH, CCN 360010
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Twin City Medical Center Hospital, Dennison, OH, CCN 361302

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samanthaquillen@dpfm.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Union Physician Services, LLC

  • Family Medicine Physician
  • Dover, OH
  • NPI 1215169826
  Medicare reassignment Care Compare group NPD
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Medicare reassignment NPD
• The Union Hospital Association

  • Community/Retail Pharmacy
  • Dover, OH
  • NPI 1023316700
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Care Compare affiliation
• Trinity Hospital Twin City

  • Critical Access Hospital
  • Dennison, OH
  • NPI 1992096192
  Care Compare affiliation

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1083018915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DUBLIN DR",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446227805",
            "telephone_number": "330-343-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DUBLIN DR",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446227805",
            "telephone_number": "330-343-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLEN",
        "first_name": "SAMANTHA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "16577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myrissa Powell, MSW, LSW
• Brenda Sue Prince, D.O.
• Pruni Chiropractic
• Pruni Chiropractic LLC
• Stephen Mark Pruni III, DC
• Annabelle Raber
• Karenann Edith Rader, BGS
• Radiology and Imaging Services, Inc
• Rancho Dialysis LLC
• Richard A Ransom, DPM

• Family Nurse Practitioner in Dover, OH
• Providers in Dover, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.