Active NPI
Samanta Wilson, APRN
- Family Nurse Practitioner
- Tampa, FL
National Provider Identifier
1396118667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP 9329330
- Practice address
- 2901 W Swann Ave
Tampa, FL 33609-4056 - Phone
- (813) 873-6400
- NPI assigned
- Nov 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP 9329330 | FL | Primary |
Addresses
Primary practice location
2901 W Swann Ave
Tampa, FL 33609-4056
Mailing address
PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002
Other practice location 1
3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 554-8690
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016709600 | Medicaid | FL | |
| JENAL | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 9329330 | FL | MD | Family Nurse Practitioner |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1396118667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10744",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337578744",
"telephone_number": "727-532-0002",
"fax_number": "727-266-4943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W SWANN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094056",
"telephone_number": "813-873-6400"
}
],
"practiceLocations": [
{
"address_1": "3001 W Dr Martin Luther King Jr Blvd",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336076307",
"country_code": "US",
"telephone_number": "813-554-8690",
"fax_number": "813-605-6068",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "SAMANTA",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-08",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP 9329330",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016709600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "JENAL",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.