Individual provider Active NPI

Samantha Daniels

  • Neonatal Nurse Practitioner
  • Austin, TX
National Provider Identifier
1164100707
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1134245 Issued in TX
Practice address
9835 N Lake Creek Pkwy
Austin, TX 78717-6210
Phone
(737) 220-8200
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1134245 TX Primary

Addresses

Primary practice location

9835 N Lake Creek Pkwy
Austin, TX 78717-6210

Mailing address

10313 Bankhead Dr
Austin, TX 78747-1719
Phone (512) 636-8883

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230928002622 TX Practitioner - Nurse Practitioner 5395199061 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1134245TXMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Hospital Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1164100707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10313 BANKHEAD DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471719",
            "telephone_number": "512-636-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9835 N LAKE CREEK PKWY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787176210",
            "telephone_number": "737-220-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "1134245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.