Individual provider Active NPI

Samantha Collins, NP

  • Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1578427779
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71017523A Issued in IN
Practice address
4055 Gateway Blvd
Newburgh, IN 47630-7451
Phone
(812) 858-3051
NPI assigned
Dec 11, 2025
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71017523A IN Primary

Addresses

Primary practice location

4055 Gateway Blvd
Newburgh, IN 47630-7451

Mailing address

PO Box 632111
Cincinnati, OH 45263-2111
Phone (812) 450-6879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20260129001154 IN Practitioner - Nurse Practitioner 6901384262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4099 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 858-3051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71017523AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Nurse Practitioner CurrentSince Dec 29, 2025 Accepting new patients
Deaconess Specialty Physicians Inc Nurse Practitioner CurrentSince Dec 29, 2025 Accepting new patients
Deaconess Specialty Physicians, Inc Nurse Practitioner Past Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4055 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2210

4099 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2720

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1765411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1578427779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632111",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632111",
            "telephone_number": "812-450-6879",
            "fax_number": "812-450-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307451",
            "telephone_number": "812-858-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71017523A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.