Individual provider Active NPI

Samuel Clark Howard Jr., PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1437858685
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024185234 Issued in VA
Practice address
1200 Five Springs Rd Ste 201
Charlottesville, VA 22902-8756
Phone
(434) 951-1229
NPI assigned
Feb 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024185234 VA Primary

Addresses

Primary practice location

1200 Five Springs Rd Ste 201
Charlottesville, VA 22902-8756

Mailing address

1200 Five Springs Rd Ste 201
Charlottesville, VA 22902-8756
Phone (434) 951-1229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240226000024 VA Practitioner - Nurse Practitioner 1456796937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
David V Hamilton MD PLLCGroup PAC ID 8123471547, 3 clinicians

Practice addresses (Care Compare)

1200 Five Springs Rd
Suite 201
Charlottesville, VA 22902-8756
Phone (434) 284-5980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024185234VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David V Hamilton MD PLLC CurrentSince Jan 12, 2024 Accepting new patients

Locations

1928 Arlington Blvd
Ste 207
Charlottesville, VA 22903
Phone (434) 906-7383

1200 Five Springs Rd
Ste 201
Charlottesville, VA 22902
Phone (434) 283-5980

Organizations & group practices 1

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1437858685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 FIVE SPRINGS RD STE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229028756",
            "telephone_number": "434-951-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 FIVE SPRINGS RD STE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229028756",
            "telephone_number": "434-951-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "SAMUEL",
        "middle_name": "CLARK",
        "name_suffix": "Jr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024185234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.