Samara A Champion, MSN, APRN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704232661NSA2109F Issued in MI

Practice address

1550 Clinton St
Muskegon, MI 49442-5007

Phone

(231) 737-1335

NPI assigned

Apr 16, 2021

Last updated

Jan 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackley Community Care Center IncGroup PAC ID 8123015492, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samarachampion@hccc.allscriptsdirect.net

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.

• Hackley Community Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1629066238

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Hackley Community Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1255669818
  NPD
• Hackley Community Care Center, Inc

  dba Hackley Community Care - Forest

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1427787621
  NPD
• Hackley Community Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1609451905
  NPD

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

• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1104407691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7834 TAYLOR RIDGE DR",
            "city": "DELTON",
            "state": "MI",
            "postal_code": "490467806",
            "telephone_number": "616-890-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 CLINTON ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425007",
            "telephone_number": "231-737-1335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Baker St",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494442157",
            "country_code": "US",
            "telephone_number": "231-737-1335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7834 Taylor Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Delton",
            "state": "MI",
            "postal_code": "490467806",
            "country_code": "US",
            "telephone_number": "616-890-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "SAMARA",
        "middle_name": "A",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2022-01-02",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704232661NSA2109F",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4704232661",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629066238",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609451905",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samarachampion@hccc.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Hackley Community Care direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2700 Baker St",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494442157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Center for Equine and Youth Rehabilitation
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• Michael J. Cerminaro, D.D.S.
• Matthew P Chadwick, D.O.
• Liz Chala
• Celine Leone Chandler
• Peter Jonas Chandler, LLPC
• Change Through Transition, LTD
• Katresa Chapman
• Ronda Gail Chapman, PT

• Family Nurse Practitioner in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; 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.