Samantha Andrea Wakefield, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN192287 Issued in GA

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(404) 295-5308

NPI assigned

Aug 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1689921538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "404-295-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "404-295-5308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Lexington Cir",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302696845",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "SAMANTHA",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN192287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Vourlos, MSW, LICSW
• Matthew Vradenburg, DC
• Carmen Lynn Vriezema, AC/ AGPCNP-BC
• Sarah Marie Waech
• William Walton Wagnild, DDS
• Brittany Alisha Ann Wakem Mottram
• Alexis Christensen Waldin, BCBA
• Susan Janet Schroeder Waldron, RN FNP
• Walgreen Co
• Walker Community Services, Inc.

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.