Samantha Tieng

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024197579 Issued in VA

Practice address

15521 Midlothian Tpke Ste 102
Midlothian, VA 23113-7313

Phone

(804) 905-8930

NPI assigned

May 28, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kidmed Inc.

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1407013121
  NPD (past)

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1124959895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11824 CARTERS CREEK DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383049",
            "telephone_number": "804-432-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15521 MIDLOTHIAN TPKE STE 102",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137313",
            "telephone_number": "804-905-8930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5021 Craig Rath Blvd",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231126243",
            "country_code": "US",
            "telephone_number": "804-592-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIENG",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024197579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Threshold Medical, PLC
• Kendall V Thurman, D.O.
• Tidewater Physical Therapy LLC
• Tidewater Physical Therapy LLC
• Tidewater Physical Therapy, LLC
• Tiesing Healthcare
• Sarah W Tiesing
• Dana M Timmer, M.A.
• Jelisa A Timmons, M.D.
• TMT Non Emergency Transportation Service LLC

• All providers in Midlothian, VA
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.