Samantha Hudson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006107RX Issued in OH

Practice address

1301 Boardman Poland Rd
Poland, OH 44514-1960

Phone

(330) 629-2300

NPI assigned

Jul 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha Gibson Former name

Medicare fee-for-service enrollment

Enrolled in PA, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations (25 of 32)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19801/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/1576/brand/1/csg/22/fhir/r4

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.

• Hometown Urgent Care of Michigan, P.C.

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385
  Medicare reassignment NPD
• Valley Medical Facilities Inc

  • General Acute Care Hospital
  • Beaver, PA
  • NPI 1063422053
  Medicare reassignment NPD
• Valley Medical Facilities Inc

  • General Acute Care Hospital
  • Sewickley, PA
  • NPI 1588770416
  Medicare reassignment NPD
• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  Medicare reassignment
• Hometown Urgent Care of Michigan, PC

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Urgent Care Clinic/Center
  • Franklin, PA
  • NPI 1619381456
  NPD
• Valley Medical Facilities Inc

  • Emergency Medicine Physician
  • MC Kees Rocks, PA
  • NPI 1699331751
  NPD
• Valley Medical Facilities, Inc.

  • General Acute Care Hospital
  • Beaver Falls, PA
  • NPI 1023830981
  NPD
• Quick Med Urgent Care LLC

  • Urgent Care Clinic/Center
  • Youngstown, OH
  • NPI 1528528726
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1508319443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BOARDMAN POLAND RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141960",
            "telephone_number": "330-629-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BOARDMAN POLAND RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141960",
            "telephone_number": "330-629-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058293",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003820",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006107RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GIBSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Kathryn Homer, MA CCC-SLP
• Hope and Healing Wellness LLC
• Kathryn Horvath, CNP
• Kathleen Ann Houk, DDS
• Robert Ross Houston, M.D.
• Melissa Marie Hudzik, CRNA
• Rae Anne Huly-Shuler, DMD
• Joseph Humphries, NCC, LSW, LPCC
• Robert E Hunt, MD
• Brian A Hutchinson

• Physician Assistant in Poland, OH
• Providers in Poland, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.