Individual provider Active NPI

Samantha Dawn Daily, NP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1386317253
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021028490 Issued in MO
Practice address
12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670
Phone
(314) 804-0977
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021028490 MO Primary

Addresses

Primary practice location

12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670

Mailing address

12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670
Phone (314) 804-0977

Other practice location 1

8011 Clayton Rd Ste 216
Richmond Heights, MO 63117-1156
Phone (314) 260-7440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211202001525 MO Practitioner - Nurse Practitioner 1052701273 Reassigns benefits to 1 organization
I20230410001257 IL Practitioner - Nurse Practitioner 1052701273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gomelb Vascular LLCGroup PAC ID 2668713884, 4 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 205
Saint Louis, MO 63141-8670
Phone (314) 255-2204

3 Park PL
Suite a
Swansea, IL 62226-2965
Phone (314) 255-2204

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
Center for Advanced Foot & Ankle Surgery Inc Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1386317253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418670",
            "telephone_number": "314-804-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418670",
            "telephone_number": "314-804-0977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8011 Clayton Rd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171156",
            "country_code": "US",
            "telephone_number": "314-260-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAILY",
        "first_name": "SAMANTHA",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021028490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.