Samantha Jo Herriott, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

DO2730 Issued in TN

Practice address

320 Bristol West Blvd
Ste 2C
Bristol, TN 37620-8772

Phone

(423) 844-1399

Fax

(423) 877-1397

NPI assigned

May 10, 2011

Last updated

Jun 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Michigan State University College of Osteopathic Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivinson Memorial HospitalGroup PAC ID 8325304447, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ivinson Memorial Hospital Hospital, Laramie, WY, CCN 530025

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ivinson Memorial Hospital

  • Rural Health Clinic/Center
  • Laramie, WY
  • NPI 1033628599
  Medicare reassignment Care Compare group NPD
• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1366626269
  NPD
• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1336289552
  NPD (past)
• Southwest Virginia Physicians for Women

  dba Abingdon Obstetrics and Gynelogy

  • Specialist
  • Abingdon, VA
  • NPI 1255326245

  Obstetrics & Gynecology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1336289552
  Care Compare affiliation

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1477845444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BRISTOL WEST BLVD",
            "address_2": "STE 2C",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376208772",
            "telephone_number": "423-844-1399",
            "fax_number": "423-877-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIOTT",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101019227",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "DO2730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Nottingham Henninger, BSW
• John R. Henritze, PA-C
• Jennifer A. Henson, M.S., CCC-A
• Tiffany Louise Henson, FNP-C
• Robert R Herndon
• Kenneth Jared Hess, DO
• Fred Wayne Hicks Jr., MD
• Jada Perry Hicks, BS
• Joshua Aaron Hicks, M.D.
• Highlands Allergy & Asthma Center PC

• Obstetrics & Gynecology Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Obstetrics & Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.