Lindsey Leann Sample, MSN, AG-ACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71009567A Issued in IN

Practice address

1101 Glendale Blvd Ste 103
Valparaiso, IN 46383-3769

Phone

(219) 464-9054

Fax

(219) 465-1749

NPI assigned

Jun 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Professionals of Indiana PCGroup PAC ID 4183604150, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsamplern70947@uchospital.direct-ci.com
• Direct secure messaging: lindsey.sample.1@2340.direct.athenahealth.com

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.

• Emergency Professionals of Indiana, P.C.

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1013951219
  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  Nurse Practitioner

  Medicare reassignment NPD
• Inphynet Primary Care Physicians Midwest, S.C.

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1528090610

  Nurse Practitioner

  Medicare reassignment NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD
• Porter Physician Services LLC

  • Internal Medicine Physician
  • Portage, IN
  • NPI 1457566309
  NPD (past)

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

• Warsaw Health System LLC

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1114588076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 KELLE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463048708",
            "telephone_number": "219-364-3616",
            "fax_number": "219-364-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GLENDALE BLVD STE 103",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833769",
            "telephone_number": "219-464-9054",
            "fax_number": "219-465-1749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 Porter Campus Dr Ste ABC",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463830089",
            "country_code": "US",
            "telephone_number": "219-464-9054",
            "fax_number": "219-464-9054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3630 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685075",
            "country_code": "US",
            "telephone_number": "219-464-9054",
            "fax_number": "219-465-1749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 E US Highway 6 Ste 210",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463838954",
            "country_code": "US",
            "telephone_number": "219-464-9054",
            "fax_number": "219-465-1749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 E US Highway 6 Ste 235",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463838948",
            "country_code": "US",
            "telephone_number": "219-464-9054",
            "fax_number": "219-465-1749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 E US Highway 6",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463838947",
            "country_code": "US",
            "telephone_number": "219-464-9054",
            "fax_number": "219-465-1749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "LINDSEY",
        "middle_name": "LEANN",
        "name_prefix": "Mrs.",
        "credential": "MSN, AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041437122",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28215273A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009567A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lindsey.sample.1@2340.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1101 Glendale Blvd Ste 103",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463833769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anmol Saggar, MD
• Florence Salai, SLP
• Melanie Salamanca
• Samantha Salas
• Dana Lynn Samardzich, LHMC, NCC, PCC
• Desiree Elizabeth Samples, DNP, RN, FNP-BC
• Tristan Sanchez
• Mary K Sandelski, RNC, CNM
• Brittney Sanders
• Jacob Sanders, RN

• Nurse Practitioner in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.