Samantha Deveney Lin, FNP-BC, MS, MPH

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.024782 Issued in IL

Practice address

1525 E 55TH St
Chicago, IL 60615-5512

Phone

(212) 305-5756

NPI assigned

Dec 26, 2020

Last updated

Jan 26, 2023By 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 4

Addresses

Other identifiers 1

Other names 1

• Samantha Deveney Leeds Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.lin.p1@direct.alegiscare.nextgenshare.com
• Direct secure messaging: samantha.lin.p2@direct.alegiscare.nextgenshare.com

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.

• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  Medicare reassignment NPD
• Howard Brown Health Center

  dba Howard Brown Health at La Casa Norte

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1427523125
  NPD
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

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

{
    "created_epoch": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1538756440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155512",
            "telephone_number": "212-305-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155512",
            "telephone_number": "212-305-5756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323917",
            "country_code": "US",
            "telephone_number": "212-305-5756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "SAMANTHA",
        "middle_name": "DEVENEY",
        "credential": "FNP-BC, MS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202011296NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024782",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "202011296NP-PP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "20140044RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209.024782",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LEEDS",
            "middle_name": "DEVENEY",
            "credential": "MS, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Holland Lin
• Pey-Yi Kevin Lin, M.D.
• Phyllis Sue Lin, PHARM.D.
• Richard H.D. Lin Jr., D.M.D.
• Rika Lin
• Shan Ru Lin, LCPC, ATR-BC, ATCS
• Shawn Lin
• Su-Mai Lin, LCSW, CADC
• Sue Lin
• William W. Lin, M.D.

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.