Individual provider Active NPI

Samantha Jo Melvin, APRN

  • Family Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1700219102
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008231 Issued in KY
Practice address
617 23Rd St Ste 215
Ashland, KY 41101-2870
Phone
(606) 408-1260
Fax
(606) 408-6327
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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 3008231 KY Primary

Addresses

Primary practice location

617 23Rd St Ste 215
Ashland, KY 41101-2870

Mailing address

PO Box 1595
Ashland, KY 41105-1595
Phone (606) 408-6200

Other identifiers 2

IdentifierTypeStateIssuer
0091405MedicaidOH
7100259280MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20131014001406 KY Practitioner - Nurse Practitioner 1153555792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashland Hospital CorporationGroup PAC ID 7719882521, 169 clinicians

Practice addresses (Care Compare)

12100 Princeland Dr
Ashland, KY 41102-7885
Phone (606) 928-2963

2201 Lexington Ave
Ashland, KY 41101-2843
Phone (606) 408-4000

Hospital & facility affiliations

  • King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

Merit-based Incentive Payment System (MIPS)

Final score
89.16 of 100Reported as group
Quality
77.42
Promoting interoperability
100
Improvement activities
40
Cost
77.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3008231KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Hospital Corporation Family CurrentSince Aug 25, 2013 Accepting new patients
Ashland Hospital Corporation Current Accepting new patients
Ashland Hospital Corporation CurrentSince Aug 25, 2013 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Oct 23, 2017 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Oct 23, 2017 Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

613 23rd St
Ste G30
Ashland, KY 41101
Phone (606) 327-0036

617 23rd St
Ste 215
Ashland, KY 41101
Phone (606) 408-1260

Interoperability endpoints

  • Direct secure messaging: smelvin21066@direct.kdhealth.us

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1700219102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411051595",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 215",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012870",
            "telephone_number": "606-408-1260",
            "fax_number": "606-408-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091405",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100259280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.