Individual provider Active NPI

Samantha Elizabeth Spina, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1427930726
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5654 Issued in OK
Practice address
1200 Childrens Ave Ste 8L
Oklahoma City, OK 73104-4637
Phone
(405) 271-4700
NPI assigned
Jul 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5654 OK Primary

Addresses

Primary practice location

1200 Childrens Ave Ste 8L
Oklahoma City, OK 73104-4637

Mailing address

14117 N Rockwell Ave Apt 10308
Oklahoma City, OK 73142-8016
Phone (412) 680-1899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20251009004736 OK Practitioner - Physician Assistant 2365949708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kelly Medical, PCGroup PAC ID 3173535515, 7 clinicians

Practice addresses (Care Compare)

13921 N Meridian Ave
Suite 100
Oklahoma City, OK 73134-1106
Phone (405) 752-9600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5654OKMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Medical, PC CurrentSince Feb 16, 2026 Accepting new patients
Ou Health Partners, Inc CurrentSince Sep 24, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Sep 24, 2025 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1200 Childrens Ave
Ste 8L
Oklahoma City, OK 73104

13921 N Meridian Ave
Ste 100
Oklahoma City, OK 73134
Phone (405) 749-0900

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1427930726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14117 N ROCKWELL AVE APT 10308",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731428016",
            "telephone_number": "412-680-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 8L",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINA",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.