Samantha Teach

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022064500 Issued in MI

Practice address

3901 Chrysler Dr Ste 3B
Detroit, MI 48201-2167

Phone

(313) 577-1396

NPI assigned

Dec 1, 2020

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

Medicare fee-for-service enrollment

Enrolled in MI

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Neighborhood Service OrganizationGroup PAC ID 7113907387, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.teach.1@19711.direct.athenahealth.com

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.

• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)

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

• VHS Detroit Receiving Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998
  Care Compare affiliation

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1366047250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER DR STE 3B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012167",
            "telephone_number": "616-822-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER DR STE 3B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012167",
            "telephone_number": "313-577-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEACH",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "2022064500",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704348939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William L. Taylor Jr., ED.D.
• Yvonne M Taylor, APRN, BC
• Tcee Group Inc
• TCW Surgical Center LLC
• Tdal Home Care LLC
• Gemia Teachey
• Taylor Jessica Teachworth
• Carson Teague, PHD
• Makalynn Jamyiah Teague
• Team Cares Inc

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.