Samantha Elledge, MSN, AGPCNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2021030042 Issued in MO

Practice address

1000 E Cherry St
Troy, MO 63379-1513

Phone

(636) 528-8551

NPI assigned

Apr 25, 2022

Last updated

Apr 25, 2022By 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 MO

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

Master of Science - Nursing

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

• Mercy Hospital Lincoln

  • Critical Access Hospital
  • Troy, MO
  • NPI 1962808733
  Medicare reassignment NPD

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1285378349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-528-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-528-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "SAMANTHA",
        "credential": "MSN, AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2021030042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan D Eckman, DC
• Tyler Ryan Eckman, DC
• Kelly C Eftink, FNP
• Eldercare Services, LLC
• Elderhaus Inn #19, LLC
• Empowered Through Counseling
• Paige Farrell
• Melanie E Fensterman, OTR L
• Finklang Eye Health Associates, LLC
• Kurt Walter Finklang, O.D.

• Primary Care Nurse Practitioner in Troy, MO
• Providers in Troy, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.