Samantha Jean Medley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP143420 Issued in TX

Practice address

5826 Esplanade Dr Ste 102
Corpus Christi, TX 78414-4198

Phone

(361) 500-2898

Fax

(361) 334-0794

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athena Medical GroupGroup PAC ID 8921358706, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Athena Medical Group

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1164918124

  Family, TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1639711799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61160",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784661160",
            "telephone_number": "361-500-2898",
            "fax_number": "361-857-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 ESPLANADE DR STE 102",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144198",
            "telephone_number": "361-500-2898",
            "fax_number": "361-334-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP143420",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Medina, LMT
• Ma Lucia Canada Medina, MD
• Zulema Medina
• Medivan EMS
• Medivita Health
• Medlines D.M.E
• Mednova Solutions LLC
• Ines Medrano
• Milan Medrano, SLP
• Thelma Haydee Medrano, OTR, MOT

• All providers in Corpus Christi, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.
• 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.