Tara Collins Samples, PH.D, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3472 Issued in TN

Practice address

3362 S 3Rd St
Memphis, TN 38109-2944

Phone

(901) 701-2510

NPI assigned

Oct 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Tara Michele Collins Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJCIAD
• Direct secure messaging: tara.samples@christchs.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IJJDAA

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.

• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1982686614
  Medicare reassignment NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1053572206
  NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, TN
  • NPI 1871299297
  NPD

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306929732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMPUS VIEW DR",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562111",
            "telephone_number": "678-643-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3362 S 3RD ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381092944",
            "telephone_number": "901-701-2510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Campus View Dr",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "IL",
            "postal_code": "626562111",
            "country_code": "US",
            "telephone_number": "678-643-9371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "TARA",
        "middle_name": "COLLINS",
        "credential": "PH.D, LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3472",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "07100827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "COLLINS",
            "middle_name": "MICHELE",
            "prefix": "MISS",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hakim Samatar
• Andrea Samberg, LCSW
• Roya Mahbobeh Sameri, PHARM. D.
• Allison Paige Samisch, DDS
• Deborah J. Samples, OTR/L
• Deshaira Sampson
• Sams East Inc
• Sams East Inc
• Shannon Samsa
• Christina Regan Samson

• Clinical Psychologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.