Samantha Michelle Peterson, A.R.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9356995 Issued in FL

Practice address

10023 S US Highway 1
Port St Lucie, FL 34952-5643

Phone

(772) 398-5339

NPI assigned

Sep 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Samantha Michelle Sierra Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1386129195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10023 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525643",
            "telephone_number": "772-398-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10023 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525643",
            "telephone_number": "772-398-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SAMANTHA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9356995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SIERRA",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth M Permar, PT, DPT
• Joseph Perretta, C.P.
• Stacey Laurein Peterkin, BT
• Christine Peterson
• Ganielle Marva Peterson, ASSISTED LIVING ADMN
• William Winston Leonard Peterson III, D.C.
• Rosemita Petion
• Julienne Petit Frere
• Dawn M Petrie, BCABA
• Matthew W Petrovic, D.C.

• Family Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.