Individual provider Active NPI

Samantha Lee Emerson, PA-C

  • Physician Assistant
  • South Haven, MI
National Provider Identifier
1083595268
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
955 S Bailey Ave Ste 200
South Haven, MI 49090-6743
Phone
(269) 639-2772
NPI assigned
Sep 11, 2025
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI Primary

Addresses

Primary practice location

955 S Bailey Ave Ste 200
South Haven, MI 49090-6743

Mailing address

955 S Bailey Ave Ste 200
South Haven, MI 49090-6743

Other practice location 1

3230 Eagle Park Dr NE
Grand Rapids, MI 49525-7007
Phone (616) 988-2229

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL direct@direct.bronsonhg.org Direct Bronson HealthCare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: semerson3391390@epic00.corewelldirect.org

NPI Registry JSON

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

{
    "created_epoch": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1083595268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE STE 200",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE STE 200",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-639-2772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3230 Eagle Park Dr NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495257007",
            "country_code": "US",
            "telephone_number": "616-988-2229",
            "fax_number": "616-988-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson HealthCare Group Direct address",
            "affiliationName": "Bronson HealthCare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

Verify at the official NPI Registry.