Individual provider Active NPI

Samantha Michelle Hutchinson

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1235619438
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145582 Issued in TX
Practice address
8723 Botts St
San Antonio, TX 78217-6334
Phone
(210) 999-5523
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP145582 TX Primary

Addresses

Primary practice location

8723 Botts St
San Antonio, TX 78217-6334

Mailing address

8723 Botts St
San Antonio, TX 78217-6334
Phone (210) 999-5523

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
I20210520000607 TX Practitioner - Nurse Practitioner 2264831478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145582TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Functional Health PLLC CurrentSince Nov 19, 2023 Accepting new patients
San Rafael Healthcare, Inc PastSince Dec 1, 2021 Accepting new patients

Locations

1602 McCullough Ave
San Antonio, TX 78212
Phone (210) 468-1891

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": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1235619438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8723 BOTTS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176334",
            "telephone_number": "210-999-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8723 BOTTS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176334",
            "telephone_number": "210-999-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "SAMANTHA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.