Individual provider Active NPI

Samuel K Kolleh Jr., D.O

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1154635027
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67495 Issued in GA
Practice address
5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone
(850) 416-6108
NPI assigned
Aug 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 67495 GA Primary

Addresses

Primary practice location

5151 N 9TH Ave
Pensacola, FL 32504-8721

Mailing address

25 Birkhall Cir
Greenville, SC 29605-5951
Phone (478) 213-3056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, SC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130327000193 GA Practitioner - General Practice 5092950873 Reassigns benefits to 3 organizations
I20140326002212 NC Practitioner - Internal Medicine 5092950873 Reassigns benefits to 5 organizations
I20180227001866 SC Practitioner - HospitalistPractitioner - Family Practice 5092950873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Houston Hospitalist Group LLCGroup PAC ID 2769813906, 48 clinicians
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Tanner Medical Center-East Alabama Hospital, Wedowee, AL, CCN 011306

Merit-based Incentive Payment System (MIPS)

Final score
87.29 of 100Reported as group
Quality
70.79
Improvement activities
40
Cost
81.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67495GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Apr 17, 2015 Accepting new patients
Houston Hospitals Inc CurrentSince Jan 15, 2013 Accepting new patients
Houston Hospitals Inc Current Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Mar 25, 2017 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Houston Hospitalist Group LLC CurrentSince May 1, 2020 Accepting new patients
Apogee Medical Group North Carolina CurrentSince Dec 25, 2017 Accepting new patients
24 On Physicians, P.C. CurrentSince Nov 14, 2015 Accepting new patients
24 On Physicians, P.C. CurrentSince Nov 14, 2015 Accepting new patients
Houston Hospitalist Group LLC CurrentSince May 1, 2020 Accepting new patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince Dec 18, 2017 Accepting new patients
Cogent Healthcare of North Carolina, PC Family Medicine CurrentSince Jun 5, 2017 Accepting new patients
Cornerstone Healthcare LLC CurrentSince Apr 17, 2015 Accepting new patients
Tanner Medical Center, Inc Family Medicine Past Accepting new patients
TMC/Villa Rica Hospital, Inc Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

233 N Houston Rd
Ste 230
Warner Robins, GA 31093

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

3990 US Highway 64 E
Murphy, NC 28906
Phone (828) 837-5939

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

218 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-7461

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 5

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1154635027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BIRKHALL CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055951",
            "telephone_number": "478-213-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLEH",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "67495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.