NPIMap

Individual provider Active NPI

Samantha Jo Mullins, MD

  • Family Medicine Physician
  • Murray, KY
National Provider Identifier
1124551858
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55704 Issued in KY
Practice address
300 S 8TH St Ste 380W
Murray, KY 42071-2442
Phone
(270) 753-0704
Fax
(270) 752-2852
NPI assigned
Apr 10, 2017
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0000063197 TN
Family Medicine Physician 207Q00000X 55704 KY Primary

Addresses

Primary practice location

300 S 8TH St Ste 380W
Murray, KY 42071-2442

Mailing address

300 S 8TH St
Murray, KY 42071-2400
Phone (270) 753-0704

Other practice location 1

803 Poplar St
Murray, KY 42071-2432
Phone (270) 762-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829003059 KY Practitioner - Family Practice 7719220474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

803 Poplar St
Murray, KY 42071-2432
Phone (270) 762-1597

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.99 of 100Reported as group
Quality
73.34
Promoting interoperability
100
Improvement activities
40
Cost
73.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55704KYMDFamily Medicine Physician
0000063197TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Murray-Calloway County Public Hospital Corporation CurrentSince Aug 1, 2022 Accepting new patients
Murray-Calloway County Public Hospital Corporation Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Murray-Calloway County Public Hospital Corporation Current Accepting new patients
Murray-Calloway County Public Hospital Corporation Past Accepting new patients

Locations

300 S 8th St
Murray, KY 42071
Phone (270) 759-1805

300 S 8th St
Ste 380W
Murray, KY 42071
Phone (270) 753-0704

300 S 8th St
Ste 480W
Murray, KY 42071
Phone (270) 762-1104

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

Interoperability endpoints

  • Direct secure messaging: samantha.mullins.1@9266.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1124551858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-753-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST STE 380W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712442",
            "telephone_number": "270-753-0704",
            "fax_number": "270-752-2852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420712432",
            "country_code": "US",
            "telephone_number": "270-762-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "0000063197",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "55704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.