Individual provider Active NPI

Samantha Rose Ashmead, PA

  • Physician Assistant
  • Watkinsville, GA
National Provider Identifier
1306453980
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9767 Issued in GA
Practice address
2061 Experiment Station Rd Ste 505
Watkinsville, GA 30677-5327
Phone
(706) 310-0324
NPI assigned
Sep 28, 2020
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9767 GA Primary

Addresses

Primary practice location

2061 Experiment Station Rd Ste 505
Watkinsville, GA 30677-5327

Mailing address

2163 Mulberry St
East Point, GA 30344-1112
Phone (254) 717-1623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20201208001434 GA Practitioner - Physician Assistant 5799197273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care of Oconee, LLCGroup PAC ID 5991090540, 14 clinicians

Practice addresses (Care Compare)

1690 Eatonton Rd
Madison, GA 30650-4628
Phone (706) 343-4044

2061 Experiment Station Rd
Watkinsville, GA 30677-5328

2061 Experiment Station Rd
Suite 505
Watkinsville, GA 30677-5327
Phone (706) 714-3562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care of Oconee, LLC CurrentSince Dec 1, 2021 Accepting new patients
Urgent Care of Oconee, LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

2375 W Broad St
Ste G
Athens, GA 30606
Phone (706) 567-6151

1690 Eatonton Rd
Madison, GA 30650
Phone (706) 342-7272

2061 Experiment Station Rd
Ste 505
Watkinsville, GA 30677
Phone (706) 310-0324

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1306453980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 MULBERRY ST",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303441112",
            "telephone_number": "254-717-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 EXPERIMENT STATION RD STE 505",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775327",
            "telephone_number": "706-310-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHMEAD",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.