Samantha Marie Hydes, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN262052 Issued in GA

Practice address

3350 Breckinridge Blvd Ste 200
Duluth, GA 30096-4959

Phone

(678) 990-6422

NPI assigned

Feb 7, 2018

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

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

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.

• Positive Impact Health Centers Inc

  • Primary Care Clinic/Center
  • Duluth, GA
  • NPI 1790861995
  Medicare reassignment NPD
• Positive Impact Health Centers, Inc.

  dba PIHC Pharmacy

  • Community/Retail Pharmacy
  • Decatur, GA
  • NPI 1912476466
  NPD
• Positive Impact Health Centers, Inc

  • Case Management Agency
  • Duluth, GA
  • NPI 1619064847
  NPD (past)

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1114426806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 BRIARCLIFF RD NE APT 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303062661",
            "telephone_number": "954-562-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 BRECKINRIDGE BLVD STE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964959",
            "telephone_number": "678-990-6422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 Church St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300302515",
            "country_code": "US",
            "telephone_number": "404-589-9040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYDES",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN262052",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN262052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Huynh, MD
• Debra Hwang, MD
• Jonathan J Hwang, D.M.D.
• Pearl Gem Hwang, D.O.
• Yosun Hwang, L.AC.
• Anne Elizabeth Hysong, APRN, CCNS, ACNS-BC
• Hyungwon Kang (Corner Pharmacy)
• I Care Home Service, LLC
• I Used Too Inc (Anytime Meals)
• Samia Idris, OD

• Family Nurse Practitioner in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.