Individual provider Active NPI

Terry Sampson, NP

  • Family Nurse Practitioner
  • Winnsboro, TX
National Provider Identifier
1093079279
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP122010 Issued in TX
Practice address
600 E Coke Rd
Winnsboro, TX 75494-3418
Phone
(903) 763-6176
NPI assigned
Jul 2, 2012
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 AP122010 TX Primary

Addresses

Primary practice location

600 E Coke Rd
Winnsboro, TX 75494-3418

Mailing address

600 E Coke Rd
Winnsboro, TX 75494-3418
Phone (903) 763-6176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120925000233 TX Practitioner - Nurse Practitioner 8628227212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quitman Hospital LLCGroup PAC ID 9133484330, shared by 6 NPIs, 29 clinicians

Practice addresses (Care Compare)

600 E Coke Rd
Winnsboro, TX 75494-3418
Phone (903) 763-6176

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP122010TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jan 15, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jan 15, 2023 Accepting new patients
Starks Medical Past Accepting new patients
Citycare Clinic PastSince Feb 4, 2024 Accepting new patients
Quitman Hospital LLC Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

Interoperability endpoints

  • Direct secure messaging: tsampson863823@ahs.direct-ci.com

Organizations & group practices 5

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 4

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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1093079279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E COKE RD",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943418",
            "telephone_number": "903-763-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E COKE RD",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943418",
            "telephone_number": "903-763-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP122010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, TX

Sources for this page

Verify at the official NPI Registry.