Samantha Marie Carter, FNP-C

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

117104 Issued in WV

Practice address

100 Main Ave
Logan, WV 25601-3323

Phone

(304) 896-2553

NPI assigned

Jul 12, 2023

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 WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Living Waters Medical Center

  • Primary Care Clinic/Center
  • Logan, WV
  • NPI 1114585619
  Medicare reassignment NPD

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1275212748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013323",
            "telephone_number": "304-896-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013323",
            "telephone_number": "304-896-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "117104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Campbell
• Brandi Nicole Canterbury, RN,BSN
• Kristy Rhyan Cantrell, PRSS-SUD
• Tyler Capua
• Carlton L W Herald DO PC Inc
• Leigh Ann Caserta
• Lisa Mae Casey
• Kirsten Chafin
• Courtney Danielle Chambers
• Hailey Nicole Chambers

• Acute Care Nurse Practitioner in Logan, WV
• Providers in Logan, WV by specialty
• Acute Care Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.