Active NPI
Samantha Welt, PA-C
- Physician Assistant
- Riverview, FL
National Provider Identifier
1205652724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9564
- Practice address
- 11948 Balm Riverview Rd
Riverview, FL 33569-6601 - Phone
- (813) 656-9553
- NPI assigned
- Nov 30, 2024
- Last updated
- May 23, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9564 | FL | Primary |
Addresses
Primary practice location
11948 Balm Riverview Rd
Riverview, FL 33569-6601
Mailing address
11948 Balm Riverview Rd
Riverview, FL 33569-6601
Phone (813) 656-9553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9564 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779494400000",
"number": "1205652724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11948 BALM RIVERVIEW RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335696601",
"telephone_number": "813-656-9553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11948 BALM RIVERVIEW RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335696601",
"telephone_number": "813-656-9553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELT",
"first_name": "SAMANTHA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-30",
"last_updated": "2026-05-23",
"certification_date": "2026-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.