NPIMap

Individual provider Active NPI

Samantha Meyer

  • Nurse Practitioner
  • Galloway, OH
National Provider Identifier
1124412879
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA 17155 Issued in OH
Practice address
6129 Nasby Dr
Galloway, OH 43119-8291
Phone
(317) 559-0950
NPI assigned
Mar 20, 2015
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA 17155 OH Primary
Nurse Practitioner 363L00000X 123657 WV

Addresses

Primary practice location

6129 Nasby Dr
Galloway, OH 43119-8291

Mailing address

PO Box 586
Galloway, OH 43119-0586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150617002100 OH Practitioner - Nurse Practitioner 9739490749 Reassigns benefits to 2 organizations
I20260330000169 WV Practitioner - Nurse Practitioner 9739490749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Mobile MD Ohio LLCGroup PAC ID 7618372442, 11 clinicians

Practice addresses (Care Compare)

Parkersburg, WV 26104
Phone (317) 559-0950

Galloway, OH 43119
Phone (765) 969-7841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
11.97 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
39.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA 17155OHMDNurse Practitioner
123657WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Ohio, Inc CurrentSince Jul 28, 2015 Accepting new patients
My Mobile MD Ohio Psychiatric Services LLC CurrentSince Jul 22, 2025 Accepting new patients
My Mobile MD Ohio LLC CurrentSince Aug 10, 2023 Accepting new patients

Locations

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

110 Nicolette Rd
Parkersburg, WV 26104
Phone (304) 424-6023

Organizations & group practices 3

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 8

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": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1124412879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431190586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 NASBY DR",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431198291",
            "telephone_number": "317-559-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA 17155",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "123657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, OH

Sources for this page

Verify at the official NPI Registry.