NPIMap

Individual provider Active NPI

Roxann M Samples, M.D.

  • Internal Medicine Physician
  • Waco, TX
National Provider Identifier
1184796252
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H2749 Issued in TX
Practice address
301 Londonderry Dr
Waco, TX 76712-7915
Phone
(254) 776-5970
NPI assigned
Nov 14, 2006
Last updated
May 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H2749 TX Primary

Addresses

Primary practice location

301 Londonderry Dr
Waco, TX 76712-7915

Mailing address

301 Londonderry Dr
Waco, TX 76712-7915
Phone (254) 776-5970

Other identifiers 3

IdentifierTypeStateIssuer
113420704MedicaidTX
8X5372OtherTXBLUE CROSS
113420703MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070705000631 TX Practitioner - Internal Medicine 2466552435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLennan County Hospitalist Services PAGroup PAC ID 1759481724, 10 clinicians

Practice addresses (Care Compare)

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H2749TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLennan County Hospitalist Services PA Internal Medicine CurrentSince Sep 27, 2006 Accepting new patients
Ascension Providence Past Accepting new patients

Locations

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1184796252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127915",
            "telephone_number": "254-776-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127915",
            "telephone_number": "254-776-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "ROXANN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H2749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113420704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8X5372",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113420703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.