Individual provider Active NPI

Samantha Lee Croft

  • Family Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1669161113
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11020090 Issued in FL
Practice address
224 Southpark Cir E
Saint Augustine, FL 32086-5135
Phone
(904) 342-4941
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 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 APRN11020090 FL Primary

Addresses

Primary practice location

224 Southpark Cir E
Saint Augustine, FL 32086-5135

Mailing address

2309 Eagle Talon Cir
Fleming Island, FL 32003-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11020090FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bailey Spine & Wellness, LLC CurrentSince Jun 1, 2023 Accepting new patients
Bailey Chiropractic Life Center Inc. PastSince May 7, 2023 Accepting new patients

Locations

224 Southpark Cir E
St Augustine, FL 32086
Phone (904) 342-4941

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1669161113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 EAGLE TALON CIR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SOUTHPARK CIR E",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865135",
            "telephone_number": "904-342-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFT",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.