NPIMap

Individual provider Active NPI

Samantha Jo Primm, FNP

  • Family Nurse Practitioner
  • Joplin, MO
National Provider Identifier
1407412406
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019015946 Issued in MO
Practice address
1532 W 32ND St
Joplin, MO 64804-1607
Phone
(417) 347-7009
NPI assigned
May 15, 2019
Last updated
May 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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 2019015946 MO Primary

Addresses

Primary practice location

1532 W 32ND St
Joplin, MO 64804-1607

Mailing address

1532 W 32ND St
Joplin, MO 64804-1607
Phone (417) 347-7009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190625000829 MO Practitioner - Nurse Practitioner 8224362272 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital CarthageGroup PAC ID 8426225251, 23 clinicians

Practice addresses (Care Compare)

3125 Dr Russell Smith Way
Mercy Hospital Carthage Emergency
Carthage, MO 64836-7402
Phone (405) 260-4165

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019015946MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Carthage CurrentSince Dec 27, 2021 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Dec 27, 2021 Accepting new patients
Mercy Hospital Carthage CurrentSince Dec 27, 2021 Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Oct 1, 2023 Accepting new patients
Freeman-Oak Hill Health System PastSince May 30, 2019 Accepting new patients

Locations

3116 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-7574

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

Organizations & group practices 5

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 11

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1407412406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041607",
            "telephone_number": "417-347-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041607",
            "telephone_number": "417-347-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMM",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019015946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.