NPIMap

Individual provider Active NPI

Samantha Puhl, PA

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1477283414
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2023009782 Issued in MO
Practice address
1235 E Cherokee St Ste 2C
Springfield, MO 65804-2203
Phone
(417) 820-2203
NPI assigned
Jun 13, 2022
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1202733
Physician Assistant 363A00000X 2023009782 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1235 E Cherokee St Ste 2C
Springfield, MO 65804-2203

Mailing address

1235 E Cherokee St Ste 2C
Springfield, MO 65804-2203
Phone (417) 820-2203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230403001192 MO Practitioner - Physician Assistant 6901271006 Reassigns benefits to 2 organizations
I20231010004109 NC Practitioner - Physician Assistant 6901271006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 28, 2023 Accepting new patients
DLP Frye Medical Group LLC CurrentSince Jan 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 20, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 30, 2023 Accepting new patients
DLP Frye Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 20, 2023 Accepting new patients
DLP Frye Medical Group LLC Physician Assistant Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

1235 E Cherokee St
Ste 2C
Springfield, MO 65804
Phone (417) 820-3919

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: samantha.puhl.1@15786.direct.athenahealth.com
  • Direct secure messaging: spuhl2755429@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 5

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1477283414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST STE 2C",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST STE 2C",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUHL",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1202733",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023009782",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.