Individual provider Active NPI

Samantha B Shawver, FNP-C

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1336505049
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN90027-FNP-BC Issued in WV
Practice address
1207 Quarrier St
Charleston, WV 25301-1826
Phone
(681) 552-2990
NPI assigned
Jan 11, 2016
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3010278 KY
Family Nurse Practitioner 363LF0000X 810074 NV
Family Nurse Practitioner 363LF0000X APRN90027-FNP-BC WV Primary

Addresses

Primary practice location

1207 Quarrier St
Charleston, WV 25301-1826

Mailing address

1505 Mount Vernon Rd
Charleston, WV 25314-2533
Phone (681) 552-2990

Other identifiers 1

IdentifierTypeStateIssuer
100519213MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20171009002486 WV Practitioner - Nurse Practitioner 5799078358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1207 Quarrier St
Charleston, WV 25301-1826
Phone (681) 552-2990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
810074NVMDFamily Nurse Practitioner
APRN90027-FNP-BCWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lasting Wellness, LLC CurrentSince Aug 1, 2025 Accepting new patients
Holistic, Inc CurrentSince Jul 3, 2019 Accepting new patients
Pikeville Medical Center Inc Past Accepting new patients

Locations

1207 Quarrier St
Charleston, WV 25301
Phone (681) 552-2990

4815 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 202-1910

303 6th Ave
Saint Albans, WV 25177
Phone (304) 721-9300

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1336505049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 MOUNT VERNON RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142533",
            "telephone_number": "681-552-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 QUARRIER ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011826",
            "telephone_number": "681-552-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWVER",
        "first_name": "SAMANTHA",
        "middle_name": "B",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010278",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "810074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN90027-FNP-BC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100519213",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.