Samantha Womeldorff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200776 Issued in LA

Practice address

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375

Phone

(225) 765-6565

NPI assigned

Oct 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Phillis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• West Toledo Urgent Care LLC

  • Urgent Care Clinic/Center
  • Toledo, OH
  • NPI 1952708000
  NPD (past)

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1457755340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 PELICAN CROSSING DR",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378616",
            "telephone_number": "440-223-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-765-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMELDORFF",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "PHILLIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Womans Gynecologic Oncology
• Womans Hospital Foundation
• Womans Hospital Foundation
• Womans Hospital Foundation
• Womans Outpatient Clinic Providers
• Womens Primary Care
• Wonder Why Counseling, LLC
• Fay Woo, MD
• Amy Wood, MD
• Angela Dawn Wood, MD

• Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.