Samantha Sue Sellers, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115984 Issued in FL

Practice address

449 W 23Rd St
Panama City, FL 32405-4507

Phone

(850) 769-8341

NPI assigned

Jan 23, 2020

Last updated

Mar 13, 2023By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, FL2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment
• Holmes County Hospital Corp

  dba Doctors Memorial Hospital

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Medicare reassignment
• Kinston Physicians Group, PLLC

  • Emergency Medicine Physician
  • Kinston, NC
  • NPI 1689923757
  Medicare reassignment
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790

  Emergency Medicine

  NPD
• FL-I Medical Services LLC

  • Emergency Medicine Physician
  • Destin, FL
  • NPI 1659720654
  NPD
• Holmes County Hospital Corp

  dba Bonifay Rural Health Clinic

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1952917015
  NPD
• The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1114153269
  NPD
• Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1760738611
  NPD

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1306476759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 ROLLING PINES RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "32428",
            "telephone_number": "904-314-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054507",
            "telephone_number": "850-769-8341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285011604",
            "country_code": "US",
            "telephone_number": "252-522-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3613 Coughlin Ct",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345979",
            "country_code": "US",
            "telephone_number": "904-314-3891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 Tarboro St SW",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278933428",
            "country_code": "US",
            "telephone_number": "252-399-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "SAMANTHA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2023-03-13",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "PA9115984",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "0010-9729",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-9729",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Second Chance of Northwest Florida
• Corinne Marie Seemuth, LMT
• Select Specialty Hospital - Panama City Inc
• Deena G. Self, LMHC
• Kolton Wade Sellers, BCBA
• Haley Senn
• Serenity South LLC
• Stephanie Kristine Serian, ARNP
• Lynn S Seto, M.D.
• Corey J Seymour, IDC

• Physician Assistant in Panama City, FL
• Providers in Panama City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.