NPIMap

Individual provider Active NPI

Samantha Marie Blackwell, NP

  • Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1164007381
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24729 Issued in SC
Practice address
1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone
(864) 583-8647
Fax
(864) 542-2227
NPI assigned
Mar 10, 2021
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24729 SC Primary

Addresses

Primary practice location

1083 Boiling Springs Rd
Spartanburg, SC 29303-2248

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
NP7493MedicaidSC
SCJ8335019OtherSCMEDICARE PIN

Other names 1

  • Samantha Bolt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210326000035 SC Practitioner - Nurse Practitioner 0648687202 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, shared by 17 NPIs, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-6193

1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone (864) 583-8647

1330 Boiling Springs Rd
Suite 2500
Spartanburg, SC 29303-4214
Phone (864) 585-5433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
24729SCMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Dec 3, 2023 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Dec 3, 2023 Accepting new patients
Union Medical Center Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 3, 2023 Accepting new patients
Pelham Medical Center CurrentSince Apr 1, 2025 Accepting new patients
Pelham Medical Center Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Charles a Thompson MD Pulmonary & Sleep PastSince Jul 31, 2023 Accepting new patients

Locations

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

2755 S Highway 14
Ste 2350
Greer, SC 29650
Phone (864) 583-8647

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

1075 Boiling Springs Rd
Ste A
Spartanburg, SC 29303
Phone (864) 583-8647

1083 Boiling Springs Rd
Spartanburg, SC 29303
Phone (803) 583-8647

1330 Boiling Springs Rd
Ste 2500
Spartanburg, SC 29303
Phone (864) 585-5433

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

1201 Furman L Fendley Hwy
Union, SC 29379
Phone (864) 301-2000

511 Cross Anchor Rd
Woodruff, SC 29388
Phone (864) 278-6031

Organizations & group practices 12

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 7

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1164007381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 BOILING SPRINGS RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032248",
            "telephone_number": "864-583-8647",
            "fax_number": "864-542-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "24729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7493",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCJ8335019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BOLT",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.