Individual provider Active NPI

Samantha Joellen Myers, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1528575545
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
98444 Issued in OK
Practice address
1717 S Utica Ave
Ste a
Tulsa, OK 74104
Phone
(918) 748-7557
Fax
(918) 403-0383
NPI assigned
Dec 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77484 KS
Family Nurse Practitioner 363LF0000X 98444 OK Primary

Addresses

Primary practice location

1717 S Utica Ave
Ste a
Tulsa, OK 74104

Mailing address

1717 S Utica Ave
Ste a
Tulsa, OK 74104-5346
Phone (918) 748-7557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 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

Enrollment IDStateProvider typePAC IDDetails
I20180608000634 OK Practitioner - Nurse Practitioner 8224383518 Reassigns benefits to 1 organization
I20180912002479 KS Practitioner - Nurse Practitioner 8224383518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Labette County Medical CenterGroup PAC ID 5496664369, shared by 16 NPIs, 74 clinicians

Practice addresses (Care Compare)

1902 S Hwy 59
Parsons, KS 67357-4948

1902 S US Hwy 59
Parsons, KS 67357-4948

Hospital & facility affiliations

  • Labette Health Hospital, Parsons, KS, CCN 170120

Merit-based Incentive Payment System (MIPS)

Final score
48.28 of 100Reported as group
Quality
21.69
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St John Urgent Care Clinics Inc CurrentSince May 20, 2018 Accepting new patients
Labette County Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Labette County Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Labette County Medical Center Family Medicine Current Accepting new patients
Labette County Medical Center Past Accepting new patients

Locations

324 S Main St
Erie, KS 66733
Phone (620) 244-3291

1902 S US Highway 59
Parsons, KS 67357
Phone (620) 421-4880

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1528575545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SAMANTHA",
        "middle_name": "JOELLEN",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "77484",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "98444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.