Samantha Jean Theobald, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27061 Issued in SC

Practice address

27 Gamecock Ave Ste 201
Charleston, SC 29407-3398

Phone

(843) 769-8215

Fax

(843) 769-8216

NPI assigned

Feb 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Curana Health of South Carolina PCGroup PAC ID 1951672617, 226 clinicians

CH Specialty Services SC LLCGroup PAC ID 6608182993, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027
• Interim Healthcare Home health agency, North Charleston, SC, CCN 427132
• Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
• Retreat at Wellmore of Daniel Island Nursing home, Charleston, SC, CCN 425414

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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.

• CH Specialty Services SC LLC

  • Family Nurse Practitioner
  • North Charleston, SC
  • NPI 1275915522
  Medicare reassignment Care Compare group NPD
• Curana Health of South Carolina PC

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1316477896
  Medicare reassignment Care Compare group NPD
• John E. Emmel, MD, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Charleston, SC
  • NPI 1235263534
  Medicare reassignment NPD

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

• Amedisys SC, LLC

  • Home Health Agency
  • Charleston, SC
  • NPI 1447218748
  Care Compare affiliation
• Lowcountry Nursing Group LLC

  • Nursing Care Agency
  • North Charleston, SC
  • NPI 1063422988

  Home health agency

  Care Compare affiliation
• Roper St. Francis Mount Pleasant Hospital

  • General Acute Care Hospital
  • Mt Pleasant, SC
  • NPI 1255645644
  Care Compare affiliation
• Wellmore of Daniel Island LLC

  • Skilled Nursing Facility
  • Charleston, SC
  • NPI 1972018026

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1508563347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 GAMECOCK AVE STE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073398",
            "telephone_number": "843-769-8215",
            "fax_number": "843-769-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GAMECOCK AVE STE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073398",
            "telephone_number": "843-769-8215",
            "fax_number": "843-769-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Middle Path at Barrier Islands
• The Next Step of SC, Inc
• The Pharmacy Club, LLC
• The Retina Center of Charleston, PA
• The Sublime Spine, LLC
• Calene Sherrie Theodore
• Therapeutic Intervention Services, Inc.
• Therapy Centers of South Carolina, P.a.
• Therapy Continuum, LLC
• Thi of South Carolina at Charleston, LLC

• Family Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.