Individual provider Active NPI

Samantha Lyn Vanvoorhis, APRN

  • Family Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1649976416
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11545 Issued in CT
Practice address
79 Wawecus St Ste 103
Norwich, CT 06360-2173
Phone
(860) 886-1862
Fax
(860) 886-2046
NPI assigned
Feb 3, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11545 CT Primary

Addresses

Primary practice location

79 Wawecus St Ste 103
Norwich, CT 06360-2173

Mailing address

79 Wawecus St Ste 103
Norwich, CT 06360-2173
Phone (860) 886-1862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230817002575 CT Practitioner - Nurse Practitioner 4789041054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Physicians of Norwich PCGroup PAC ID 5092601955, 10 clinicians

Practice addresses (Care Compare)

196 Waterford Pkwy S
Suite 101
Waterford, CT 06385-1234
Phone (860) 886-1862

558 Norwich Rd
Plainfield, CT 06374-1725
Phone (860) 886-1862

79 Wawecus St
Suite 103
Norwich, CT 06360-2173
Phone (860) 886-1862

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
74.91
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Physicians of Norwich PC CurrentSince Jun 21, 2023 Accepting new patients

Locations

79 Wawecus St
Ste 103
Norwich, CT 06360
Phone (860) 886-1862

330 Washington St
Ste 430
Norwich, CT 06360
Phone (860) 886-1862

558 Norwich Rd
Plainfield, CT 06374
Phone (860) 564-4054

Organizations & group practices 1

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 7

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": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1649976416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST STE 103",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602173",
            "telephone_number": "860-886-1862",
            "fax_number": "860-886-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST STE 103",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602173",
            "telephone_number": "860-886-1862",
            "fax_number": "860-886-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVOORHIS",
        "first_name": "SAMANTHA",
        "middle_name": "LYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.