Samantha Gump, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557672 Issued in VA

Practice address

13850 Booker T Washington Hwy
Moneta, VA 24121-6205

Phone

(941) 713-1392

NPI assigned

Feb 2, 2019

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

122 Chiropractic Corp.Group PAC ID 7315358694, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 122 Chiropractic Corp.

  • Chiropractor
  • Moneta, VA
  • NPI 1831790351
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1549065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1407311533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13850 BOOKER T WASHINGTON HWY",
            "city": "MONETA",
            "state": "VA",
            "postal_code": "241216205",
            "telephone_number": "941-713-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13850 BOOKER T WASHINGTON HWY",
            "city": "MONETA",
            "state": "VA",
            "postal_code": "241216205",
            "telephone_number": "941-713-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMP",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-02",
        "last_updated": "2024-02-26",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12710",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren N Gilman, DPT, PT
• Jazmin Mecarra Gray, PA-C
• Ronald G Greer, MS/PT/OTR
• Phillip Eugene Gruber, R.PH.
• Robert Gump IV, DC
• Christine Ann Haessler, RPH
• Leonard Hammond
• Diane Rose Hancock, LPTA
• Patricia H Hayes, NP
• Henry Burgess, MD, PC

• Chiropractor in Moneta, VA
• Providers in Moneta, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.