Individual provider Active NPI

Anna R Samuel, ACNP

  • Acute Care Nurse Practitioner
  • Denison, TX
National Provider Identifier
1639312671
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP124352 Issued in TX
Practice address
5026 Pool Rd
Denison, TX 75020-4595
Phone
(903) 465-3624
Fax
(903) 465-3973
NPI assigned
Apr 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 716738 TX
Acute Care Clinical Nurse Specialist 364SA2100X 13998 TN
Acute Care Nurse Practitioner 363LA2100X AP124352 TX Primary

Addresses

Primary practice location

5026 Pool Rd
Denison, TX 75020-4595

Mailing address

5012 S US Highway 75 Ste 300
Denison, TX 75020-4589
Phone (903) 465-3624

Other practice location 1

209 S Church St
Suite A
Lockhart, TX 78644-2713
Phone (512) 376-2183

Other practice location 2

1180 Seton Pkwy Ste 450
Kyle, TX 78640-6178
Phone (512) 504-0860

Other practice location 3

6300 W Parker Rd Ste 322
Plano, TX 75093-8103
Phone (972) 981-7870

Other identifiers 5

IdentifierTypeStateIssuer
329130401MedicaidTX
329130402MedicaidTX
8515NFOtherTXBCBS
331622YMGJOtherTXMEDICARE PIN
329130404MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140219001599 TX Practitioner - Nurse Practitioner 9931259314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

6601 Preston Rd
Plano, TX 75024-2502
Phone (469) 326-3400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
716738TXMDAcute Care Nurse Practitioner
AP124352TXMDAcute Care Nurse Practitioner
13998TNMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 6, 2024 Accepting new patients
M.Asad Karim M.D.P.a. CurrentSince Oct 28, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince May 6, 2024 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Texomacare Past Accepting new patients
Smyrna Medical Group LLC Past Accepting new patients
Star Medical Group, LLC Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

1871 Harroun Ave
Ste 200
McKinney, TX 75069
Phone (214) 491-6365

6601 Preston Rd
Plano, TX 75024
Phone (469) 326-3400

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: asamuel698584@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639312671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 300",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204589",
            "telephone_number": "903-465-3624",
            "fax_number": "903-465-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 POOL RD",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204595",
            "telephone_number": "903-465-3624",
            "fax_number": "903-465-3973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 S Church St",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Lockhart",
            "state": "TX",
            "postal_code": "786442713",
            "country_code": "US",
            "telephone_number": "512-376-2183",
            "fax_number": "512-324-3449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1180 Seton Pkwy Ste 450",
            "address_purpose": "LOCATION",
            "city": "Kyle",
            "state": "TX",
            "postal_code": "786406178",
            "country_code": "US",
            "telephone_number": "512-504-0860",
            "fax_number": "512-504-0861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6300 W Parker Rd Ste 322",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938103",
            "country_code": "US",
            "telephone_number": "972-981-7870",
            "fax_number": "972-981-7886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ANNA",
        "middle_name": "R",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "716738",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "TN",
            "license": "13998",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP124352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329130401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329130402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8515NF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "331622YMGJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329130404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.