Active NPI
Samantha Fresia Johnson, CNP
- Nurse Practitioner
- Athens, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0036739
- Practice address
- 2131 E State St
Athens, OH 45701-2138 - Phone
- (740) 589-3100
- Fax
- (740) 566-4014
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0036739 | OH | Primary |
Addresses
Primary practice location
2131 E State St
Athens, OH 45701-2138
Mailing address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5000
Other names 1
- Samantha Lyall
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | samantha.johnson1@17389.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0036739 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holzer Clinic, LLC | Current | Accepting new patients | |
| I Path LLC | Current | Accepting new patients |
Locations
2131 E State St
Athens, OH 45701
Phone (740) 589-3100
90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131
100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050
280 Pattonsville Rd
Jackson, OH 45640
Phone (740) 395-8805
88 E Memorial Dr
Pomeroy, OH 45769
Phone (740) 992-0060
Interoperability endpoints
- samantha.johnson.1@17389.direct.athenahealth.com
- samantha.johnson1@17389.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Gallipolis, OH
- NPI 1508817248
-
- Anatomic Pathology & Clinical Pathology Physician
- Gallipolis, OH
- NPI 1942525563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1619710563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 E STATE ST",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012138",
"telephone_number": "740-589-3100",
"fax_number": "740-566-4014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SAMANTHA",
"middle_name": "FRESIA",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2025-04-22",
"certification_date": "2025-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "0036739",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "samantha.johnson1@17389.direct.athenahealth.com",
"affiliation": "N",
"address_1": "2131 E State St",
"city": "Athens",
"state": "OH",
"country_code": "US",
"postal_code": "457012138",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "LYALL",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.