Samantha Watanapongse Pollock, A.P.R.N.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2020038833 Issued in MO

Practice address

12125 Woodcrest Executive Dr Ste 110
Saint Louis, MO 63141-5009

Phone

(314) 789-2486

NPI assigned

Aug 19, 2016

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 MO

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Bridgeton, MO, CCN 267595

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 and National Provider Directory roles.

• United Wound Care, LLC

  • Wound Care Registered Nurse
  • Saint Louis, MO
  • NPI 1124893888
  Medicare reassignment NPD
• Altus Surgical&Urology Associates, PLLC

  • Specialist
  • Altus, OK
  • NPI 1962716597
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

• Pyramid Home Health, Inc

  • Home Health Agency
  • Bridgeton, MO
  • NPI 1548207475
  Care Compare affiliation

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1366997306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415009",
            "telephone_number": "314-789-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "SAMANTHA",
        "middle_name": "WATANAPONGSE",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "0121921",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2020038833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Helen Pollard, MD
• Stephanie K Polley
• Connie M. Pollock, O.D.
• Monta Kay Pollock, P.T.
• Patricia Marie Pollock
• Kenneth S Polonsky, MD
• Ilir Polovina, NP-C
• Galina A Polska
• Jessica Polson, PSY.D.
• Susan Polson

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.