Destiny Patrice Samuels

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

005702 Issued in GA

Practice address

300 E Hospital Road
Fort Eisenhower, GA 30905

Phone

(706) 787-5811

NPI assigned

Mar 4, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1184422446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL ROAD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL ROAD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "DESTINY",
        "middle_name": "PATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "005702",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1186260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatjana Estep Raycroft, LCSW, MAC
• Meghan Reese
• James Aaron Resch, PHD
• Juan Antonio Rodriguez Jr.
• Gregory Ruddy
• Brent Schilling, DO
• Stacia Frances Schmidt, LCSW
• Spencer S Schulte, MD
• Taylor Paige Schuyten, DO
• Rachelle Yvonne Scuderi, DO

• Registered Nurse in Fort Eisenhower, GA
• Providers in Fort Eisenhower, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.