Individual provider Active NPI

Samantha Kay King, CNM, RN

  • Maternal Newborn Registered Nurse
  • Fort Wayne, IN
National Provider Identifier
1679412357
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
28250820A Issued in IN
Practice address
2512 E Dupont Rd Ste 105
Fort Wayne, IN 46825-0045
Phone
(260) 222-7401
NPI assigned
Mar 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X
Maternal Newborn Registered Nurse 163WM0102X 28250820A IN Primary

Addresses

Primary practice location

2512 E Dupont Rd Ste 105
Fort Wayne, IN 46825-0045

Mailing address

4014 Fernbank Dr
Fort Wayne, IN 46815-5410

Other practice location 1

9835 Auburn Rd
Fort Wayne, IN 46825-2347
Phone (260) 222-7406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife, Registered Nurse

State licenses

LicenseStateTypeSpecialty
28250820AINMDMaternal Newborn Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1679412357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 FERNBANK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 E DUPONT RD STE 105",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468250045",
            "telephone_number": "260-222-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9835 Auburn Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468252347",
            "country_code": "US",
            "telephone_number": "260-222-7406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "SAMANTHA",
        "middle_name": "KAY",
        "credential": "CNM, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "IN",
            "license": "28250820A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.