Individual provider Active NPI

Dustie Angela Samuels, D.O.

  • Family Medicine Physician
  • Junction City, KS
National Provider Identifier
1386026953
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-39445 Issued in KS
Practice address
361 Grant Ave
Junction City, KS 66441-4201
Phone
(785) 238-4711
NPI assigned
Jun 19, 2015
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024038767 MO
Family Medicine Physician 207Q00000X 05-39445 KS Primary

Addresses

Primary practice location

361 Grant Ave
Junction City, KS 66441-4201

Mailing address

361 Grant Ave
Junction City, KS 66441-4201
Phone (785) 238-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170420001630 KS Practitioner - Family Practice 7810201902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Konza Prairie Community Health Center IncGroup PAC ID 3779483466, shared by 3 NPIs, 20 clinicians

Practice addresses (Care Compare)

222 N 6TH St
Suite 100
Manhattan, KS 66502-4956
Phone (785) 320-7134

361 Grant Ave
Junction City, KS 66441-4201
Phone (785) 238-4711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2024038767MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Konza Prairie Community Health Center, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Konza Prairie Community Health Center, Inc. Current Accepting new patients
Konza Prairie Community Health Center, Inc. CurrentSince Mar 4, 2024 Accepting new patients

Locations

361 Grant Ave
Junction City, KS 66441
Phone (785) 238-4711

222 N 6th St
Ste 100
Manhattan, KS 66502
Phone (785) 320-7134

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAFCAD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Konza Prairie Community Health and Dental CenterJunction City, KS, CCN 171804 Federally qualified health center W-2 Managing Employee Mar 4, 2024
Konza Prairie Community Health Center Chapman ClinicChapman, KS, CCN 171037 Federally qualified health center W-2 Managing Employee Mar 4, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1386026953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 GRANT AVE",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414201",
            "telephone_number": "785-238-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 GRANT AVE",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414201",
            "telephone_number": "785-238-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "DUSTIE",
        "middle_name": "ANGELA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024038767",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-39445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

Verify at the official NPI Registry.