Samantha Mitchell, AGPCNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP138426 Issued in TX

Practice address

4480 S Cobb Dr SE Ste 503
Smyrna, GA 30080-6990

Phone

(404) 946-1800

NPI assigned

Feb 27, 2013

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

Enrolled in TX

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 1

Merit-based Incentive Payment System (MIPS)

Final score

79.54 of 100Reported as group

Quality

72.94

Improvement activities

40

Cost

48.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Collaborative Geriatrics Inc

  • Gerontology Nurse Practitioner
  • Katy, TX
  • NPI 1811088628
  Medicare reassignment NPD
• Med Management Associates

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1508233040
  Medicare reassignment NPD
• Vohra Post Acute Care Physicians of Texas, PLLC

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1821424789
  Medicare reassignment NPD
• Colby D. Healthcare Inc.

  • Home Health Agency
  • Houston, TX
  • NPI 1184714008
  NPD (past)
• Union Hospital of Cecil County

  dba Open MRI and Imaging at Principio

  • Radiology Clinic/Center
  • Perryville, MD
  • NPI 1922246206
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1144560137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3728 KELVIN AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332946",
            "telephone_number": "682-552-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 S COBB DR SE STE 503",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806990",
            "telephone_number": "404-946-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9888 Bissonnet St",
            "address_2": "#670",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770368247",
            "country_code": "US",
            "telephone_number": "832-563-4970",
            "fax_number": "713-774-1842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3728 Kelvin Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761332946",
            "country_code": "US",
            "telephone_number": "682-552-0594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SAMANTHA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP138426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Andrea Nicole Mingo
• Winellen Miranda
• Kunal Mitra, MD, MBA
• MLC Consulting, LLC
• Evan Russell Mobley, COTA
• Edith Mobolade, DC
• Modern Teleradiology, LLC

• Gerontology Nurse Practitioner in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.