Individual provider Active NPI

Amanda K Sams, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1619021771
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
681288 Issued in TX
Practice address
4916 Overton PLZ
Fort Worth, TX 76109-4415
Phone
(888) 804-3000
Fax
(817) 877-0350
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 681288 TX Primary

Addresses

Primary practice location

4916 Overton PLZ
Fort Worth, TX 76109-4415

Mailing address

4916 Overton PLZ
Fort Worth, TX 76109-4415
Phone (888) 804-3000

Other identifiers 1

IdentifierTypeStateIssuer
192040704MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000600 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204927593 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Christus Health Ark-la-TexGroup PAC ID 2264325588, 39 clinicians

Practice addresses (Care Compare)

1902 Moores LN
Suite B
Texarkana, TX 75503-4668
Phone (903) 792-2108

2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone (903) 614-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Health Ark-la-Tex Current Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Feb 7, 2007 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Feb 3, 2020 Accepting new patients
Texarkana Gastroenterology Consultants, PA CurrentSince Oct 24, 2013 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Dec 21, 2018 Accepting new patients
Christus Health Ark-la-Tex CurrentSince Feb 3, 2020 Accepting new patients
Medical Center Medical Group Past Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

11212 State Highway 151
Ste 12
San Antonio, TX 78251

1902 Moores Ln
Ste B
Texarkana, TX 75503
Phone (903) 792-2108

1920 Moores Ln
Ste A
Texarkana, TX 75503
Phone (903) 792-8030

2604 Saint Michael Dr
Ste 239
Texarkana, TX 75503
Phone (903) 614-5330

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • FHIR API: https://ab0ad0d3-1a1d-47a7-80b0-c0bd276b844e.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 8

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 3

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1619021771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4916 OVERTON PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094415",
            "telephone_number": "888-804-3000",
            "fax_number": "817-877-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 OVERTON PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094415",
            "telephone_number": "888-804-3000",
            "fax_number": "817-877-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "681288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192040704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.