Individual provider Active NPI

Christina Marie Samaritoni, FNP

  • Acute Care Nurse Practitioner
  • Fairfax, MO
National Provider Identifier
1457074783
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2022049299 Issued in MO
Practice address
26136 Highway 59
Fairfax, MO 64446-2295
Phone
(660) 686-2368
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 2020006013 MO
Acute Care Nurse Practitioner 363LA2100X 53-81806-121 KS
Acute Care Nurse Practitioner 363LA2100X 2022049299 MO Primary

Addresses

Primary practice location

26136 Highway 59
Fairfax, MO 64446-2295

Mailing address

26136 Highway 59
Fairfax, MO 64446-2295
Phone (660) 686-2368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240502003036 KS Practitioner - Nurse Practitioner 5991145229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020006013MOMDGeneral Practice Registered Nurse
53-81806-121KSMDAcute Care Nurse Practitioner
2022049299MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kanza Mental Health and Guidance Center, Inc. CurrentSince Mar 24, 2024 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

909 S 2nd St
Hiawatha, KS 66434
Phone (785) 742-7113

Organizations & group practices 2

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": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1457074783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26136 HIGHWAY 59",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644462295",
            "telephone_number": "660-686-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26136 HIGHWAY 59",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644462295",
            "telephone_number": "660-686-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARITONI",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MO",
            "license": "2020006013",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "53-81806-121",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2022049299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, MO

Sources for this page

Verify at the official NPI Registry.