Individual provider Active NPI

Samantha Ann Dotson, NP-C

  • Family Nurse Practitioner
  • Tiffin, OH
National Provider Identifier
1760849731
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.18638-NP Issued in OH
Practice address
455 W Market St
Tiffin, OH 44883-2670
Phone
(419) 448-8118
NPI assigned
Jan 21, 2016
Last updated
Jan 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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 COA.18638-NP OH Primary

Addresses

Primary practice location

455 W Market St
Tiffin, OH 44883-2670

Mailing address

70 N Township Road 207
Tiffin, OH 44883-9668
Phone (419) 618-4449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160517000769 OH Practitioner - Nurse Practitioner 9537458443 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Family CurrentSince Jun 1, 2016 Accepting new patients
Incare Health Solutions LLC CurrentSince Mar 9, 2016 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Mar 9, 2016 Accepting new patients
Fort Ball Emergency Physicians LLC Past Accepting new patients

Locations

175 Edgefield Blvd
Marion, OH 43302
Phone (740) 751-6433

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1760849731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 N TOWNSHIP ROAD 207",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448839668",
            "telephone_number": "419-618-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W MARKET ST",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832670",
            "telephone_number": "419-448-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.18638-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.