Samantha Sophia Peckham, APRN FNP-BC PMHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

001667 Issued in NV

Practice address

10040 W Cheyenne Ave Ste 170
Las Vegas, NV 89129-7721

Phone

(702) 907-5080

Fax

(702) 725-1416

NPI assigned

Mar 26, 2014

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

Other names 1

• Samantha Sophia Sims Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: speckham10472@direct.umcsn.com
• Direct secure messaging: samantha.peckham.1@14940.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.

• Carefirst Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1013527845
  NPD
• Evensen & Trippi PLLC

  • Obesity Medicine (Internal Medicine) Physician
  • Las Vegas, NV
  • NPI 1962769950
  NPD (past)
• Evensen and Trippi Mens Health PLLC

  • Obesity Medicine (Internal Medicine) Physician
  • Las Vegas, NV
  • NPI 1033476023
  NPD (past)

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1134546286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4898 AL CARRISON ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493279",
            "telephone_number": "702-738-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 W CHEYENNE AVE STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297721",
            "telephone_number": "702-907-5080",
            "fax_number": "702-725-1416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 S Jones Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891463151",
            "country_code": "US",
            "telephone_number": "702-463-3631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "SAMANTHA",
        "middle_name": "SOPHIA",
        "name_prefix": "Mrs.",
        "credential": "APRN FNP-BC PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "1667",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "001667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SIMS",
            "middle_name": "SOPHIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Peck
• Nichol Peck, BCBA
• Skyler Peck
• Steven D. Peck, D,C
• Victoria Kylee Peckham Smith
• Pecos Medical Group
• Pecos Surgery Center LLC
• Froilan Pecson
• Pedaitric Dental Associates
• Suneal Gopal Peddada, DO

• Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.