Samara Marie Williamson, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2022005952 Issued in MO

Practice address

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004

Phone

(636) 237-4700

NPI assigned

Feb 17, 2022

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 KS, IL, OK, CT, TX5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: swilliamson996901@directc.mercy.net

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.

• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  CT, IL, KS, OK, TX

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1285389304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MARIANNE DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762201",
            "telephone_number": "740-502-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-237-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "SAMARA",
        "middle_name": "MARIE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2022005952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Sedgwick MD Orthopaedic Surgery and Sports Medicine PC
• Tamara Joan Williams-Reding, M.ED., LPC
• Fred Harrison Williams, MD
• James L Williams II, MD
• Kristine G Williams, MD
• Kristen M Willingham, AGNP
• Sarah Ann Willis, PT
• Elizabeth M Wilmes, CRNA
• Sarah M Wilmsmeyer, PA-C
• Holly Wilson, MA, MFT

• Gerontology Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.
• 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.