Individual provider Active NPI

Samantha Jones, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bel Air, MD
National Provider Identifier
1659981264
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R204270 Issued in MD
Practice address
260 Gateway Dr
Bel Air, MD 21014-4268
Phone
(410) 286-1258
NPI assigned
Aug 7, 2020
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R204270 MD Primary

Addresses

Primary practice location

260 Gateway Dr
Bel Air, MD 21014-4268

Mailing address

260 Gateway Dr
Bel Air, MD 21014-4268
Phone (410) 286-1258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20201013002329 MD Practitioner - Nurse Practitioner 6305266321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellness Legacy LLCGroup PAC ID 1052743457, 5 clinicians

Practice addresses (Care Compare)

1016 Dulaney Valley Rd
Towson, MD 21204-2702
Phone (410) 286-1258

754 N Hickory Ave
Suite B
Bel Air, MD 21014-3042
Phone (410) 286-1258

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Legacy LLC Psychiatric/Mental Health Current Accepting new patients
Advantage Psychiatric Services LLC CurrentSince Oct 6, 2020 Accepting new patients
Advantage Psychiatric Services LLC CurrentSince Oct 6, 2020 Accepting new patients
Wellness Legacy LLC Psychiatric/Mental Health CurrentSince Oct 1, 2020 Accepting new patients

Locations

306 W Pulaski Hwy
Elkton, MD 21921
Phone (410) 392-3417

910 Revolution St
Hvre de Grace, MD 21078
Phone (410) 919-9665

5024 Campbell Blvd
Ste A
Nottingham, MD 21236
Phone 4106863629110

7652 Belair Rd
Ste A
Nottingham, MD 21236
Phone (410) 508-0722

1016 Dulaney Valley Rd
Ofc
Towson, MD 21204
Phone (410) 286-1258

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1659981264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144268",
            "telephone_number": "410-286-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144268",
            "telephone_number": "410-286-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SAMANTHA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R204270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.