Individual provider Active NPI

Samantha Gary

  • Physician Assistant
  • Wabash, IN
National Provider Identifier
1396462800
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004134A Issued in IN
Practice address
1146 N Cass St Ste C
Wabash, IN 46992-1082
Phone
(260) 560-3001
NPI assigned
Oct 25, 2022
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 10004134A IN Primary

Addresses

Primary practice location

1146 N Cass St Ste C
Wabash, IN 46992-1082

Mailing address

1146 N Cass St Ste C
Wabash, IN 46992-1082
Phone (260) 560-3001

Other practice location 1

2800 Walmart Dr
Huntington, IN 46750-7977
Phone (260) 200-4960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20231213001385 IN Practitioner - Physician Assistant 6406205665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Medical Clinic LLCGroup PAC ID 1951721802, 30 clinicians
Bradley Bibb MD PLLCGroup PAC ID 4789715285, 71 clinicians

Practice addresses (Care Compare)

1641 S US Hwy 231
Crawfordsville, IN 47933-9421
Phone (865) 436-2811

2800 Walmart Dr
Huntington, IN 46750-7977
Phone (260) 200-4950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Bibb MD PLLC CurrentSince Apr 25, 2025 Accepting new patients
Access Medical Clinic LLC CurrentSince Oct 29, 2023 Accepting new patients
Bradley Bibb MD PLLC CurrentSince Apr 25, 2025 Accepting new patients
Access Medical Clinic LLC CurrentSince Oct 29, 2023 Accepting new patients
Access Medical Clinic LLC Past Accepting new patients

Locations

4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100

1641 S US Highway 231
Crawfordsvlle, IN 47933
Phone (765) 307-7146

2800 Walmart Dr
Huntington, IN 46750
Phone (260) 200-4950

2001 S 1st St
Chickasha, OK 73018
Phone (405) 224-0292

2400 S Country Club Rd
El Reno, OK 73036
Phone (405) 262-6112

Organizations & group practices 7

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": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1396462800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 N CASS ST STE C",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921082",
            "telephone_number": "260-560-3001",
            "fax_number": "260-560-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 N CASS ST STE C",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921082",
            "telephone_number": "260-560-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Walmart Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "IN",
            "postal_code": "467507977",
            "country_code": "US",
            "telephone_number": "260-200-4960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARY",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004134A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabash, IN

Sources for this page

Verify at the official NPI Registry.