Samantha Lynn Blum
Individual provider Active NPI Peer Specialist · Adrian, MO
NPI 1295693240 · NPPES record last updated Jan 9, 2026
Key facts
- NPI
- 1295693240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 20564 (MO)
- Practice address
- 57 E Main St
Adrian, MO 64720-8201 - Phone
- (816) 372-2948
- NPI assigned
- Jan 9, 2026
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20564 | MO | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Code 1 Wellness | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 20564 | MO | Yes |
Addresses
Primary practice location
57 E Main St
Adrian, MO 64720-8201
Mailing address
7000B NW State Route 18
Adrian, MO 64720-4807
Phone (816) 267-8283
Other providers in Adrian, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.