Samantha Grace Boren, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

BORE-TLLM8M Issued in MS

Practice address

609 Brunson Dr Ste B
Tupelo, MS 38801-4948

Phone

(662) 432-1097

Fax

(833) 707-1951

NPI assigned

Jul 24, 2023

Last updated

Jul 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26357/brand/1/csg/1/fhir/r4
• Direct secure messaging: samantha.boren.1@26357.direct.athenahealth.com

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.

• Region IV Mental Health Services

  dba Timber Hills Mental Health

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  Medicare reassignment NPD
• Region IV Mental Health Services

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD
• The Chadwick Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tupelo, MS
  • NPI 1801538186
  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1245910298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350480",
            "telephone_number": "662-432-1097",
            "fax_number": "833-707-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 BRUNSON DR STE B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014948",
            "telephone_number": "662-432-1097",
            "fax_number": "833-707-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "SAMANTHA",
        "middle_name": "GRACE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "BORE-TLLM8M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy L Boles, M.D.
• Dennis Davis Bond Sr., D.M.D.
• Bethany Bonner, M.ED.
• Carla Booker, SLP
• Katelyn C Boren
• Sharon Dugas Boudreaux, BCBA
• Charles Edward Bouldin, R.P.T.
• Keisha Bounds
• Makenna Bourland, PA-C
• Kevin Boutin, O.T.

• Psychiatric/Mental Health Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.