Samantha Claybern, NP
Individual provider Active NPI Family Nurse Practitioner · Prospect, KY
NPI 1639729312 · NPPES record last updated Sep 16, 2019
Key facts
- NPI
- 1639729312
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3013785 (KY)
- Practice address
- 9537 US Highway 42
Prospect, KY 40059-9301 - Phone
- (502) 713-1332
- NPI assigned
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Indiana University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Elite Internal Medicine
Practice addresses (Care Compare)
10501 Fischer Park Dr
Louisville, KY 40241-4139
Phone (502) 713-1332
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201002001298 | KY | Practitioner - Nurse Practitioner | 9436578945 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3013785 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Internal Medicine | Current |
Accepting new patients |
Locations
10501 Fischer Park Dr
Louisville, KY 40241
Phone (502) 713-1218
9537 US Highway 42
Prospect, KY 40059
Phone (502) 713-1332
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3013785 | KY | Yes |
Addresses
Primary practice location
9537 US Highway 42
Prospect, KY 40059-9301
Mailing address
2214 Morgan Ridge CT
La Grange, KY 40031-8688
Phone (859) 912-5832
Other names
- Samantha Claybern
Other providers in Prospect, KY
- Michael Dathan Chesnut
- Melinda Gaylor Childress
- Chit Chat and Chew LLC
- Gregory John Ciliberti
- Salvatore A Ciliberti
- Clear Ears
- Clear Ears
- Sarah Ann Clunie
- Kendra Denise Coleman
- Alyson Nicole Cooper
All providers in Prospect, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.