Individual provider Active NPI

Samantha Roberta Kite, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1104016948
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R157782 Issued in MD
Practice address
4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone
(410) 542-8130
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R157782 MD
Family Nurse Practitioner 363LF0000X R157782 MD Primary

Addresses

Primary practice location

4340 Park Heights Ave
Baltimore, MD 21215-6725

Mailing address

4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone (443) 204-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20080731000148 MD Practitioner - Nurse Practitioner 6901970540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Heights Medical Clinic LLCGroup PAC ID 7012012651, 7 clinicians

Practice addresses (Care Compare)

4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone (410) 542-8130

5010 York Rd
Baltimore, MD 21212-4444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R157782MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Heights Medical Clinic LLC CurrentSince Mar 31, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4340 Park Heights Ave
Baltimore, MD 21215
Phone (410) 542-8130

301 International Cir
Hunt Valley, MD 21030
Phone (410) 433-2200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1104016948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "443-204-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "410-542-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITE",
        "first_name": "SAMANTHA",
        "middle_name": "ROBERTA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R157782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R157782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.