Samuel R Haliburton, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1056783 Issued in TX

Practice address

403 Berwick St
Victoria, TX 77904-2889

Phone

(361) 772-0052

NPI assigned

Nov 3, 2021

Last updated

Nov 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Medical Center County of VictoriaGroup PAC ID 3577785096, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Medical Center Hospital, Victoria, TX, CCN 450023

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Citizen's Medical Center County of Victoria

  dba Citizens Medical Professional

  • Multi-Specialty Clinic/Center
  • Victoria, TX
  • NPI 1205242088

  Family

  Medicare reassignment Care Compare group NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  Care Compare affiliation

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1336804525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BERWICK ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042889",
            "telephone_number": "361-772-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BERWICK ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042889",
            "telephone_number": "361-772-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALIBURTON",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio E Hachem, OD
• John Hagan, C.R.N.A.
• Lisa Marie Hagan, R.D., L.D.
• Jennifer Marie Hahn, LVN
• Valerie E Hahn, APRN, FNP-C
• Susan Delaine Hall, P.A.C.
• Hamilton County Hospital District (Riverside Oaks)
• Kathleen G Hamilton, O.D.
• Sean Michael Hamilton, M.D.
• Brendan Joseph Hammack, RN

• Family Nurse Practitioner in Victoria, TX
• Providers in Victoria, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.