Samantha Anne Wannos, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9282492 Issued in FL

Practice address

3131 N McMullen Booth Rd
Clearwater, FL 33761

Phone

(727) 726-8871

Fax

(727) 726-8571

NPI assigned

Apr 12, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, MN, VT, ME, WI, NY6 enrollments

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 6

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifemd Southern Patient Medical Care PCGroup PAC ID 7618311820, 6 clinicians

Lifemd Atlantic Patient Medical Care PCGroup PAC ID 2163868217, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 35)

Interoperability endpoints

• Direct secure messaging: samantha.wannos@337577483108356.direct.elationemr.com

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.

• Lifemd Southern Patient Medical Care PC

  • Clinic/Center
  • Orlando, FL
  • NPI 1417635921
  Medicare reassignment Care Compare group NPD
• Lifemd Atlantic Patient Medical Care PC

  • Clinic/Center
  • Hoboken, NJ
  • NPI 1164100657

  FL

  Medicare reassignment Care Compare group NPD
• Lifemd Kansas Patient Medical Care PA

  • Clinic/Center
  • Overland Park, KS
  • NPI 1073353850

  FL

  Medicare reassignment NPD
• New York Patient Medical Care PC

  • Multi-Specialty Clinic/Center
  • Rochester, NY
  • NPI 1629757919

  FL

  Medicare reassignment NPD
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661

  ME, VT

  Medicare reassignment NPD
• Puopolo MD PC

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1477230928

  FL

  Medicare reassignment NPD
• Lifemd Midwest Patient Medical Care PC

  • Clinic/Center
  • Troy, MI
  • NPI 1497433734
  NPD
• Openloop Healthcare Partners Colorado, PC

  • General Practice Physician
  • Denver, CO
  • NPI 1912678012
  NPD
• Openloop Healthcare Partners Wisconsin, SC

  • General Practice Physician
  • Madison, WI
  • NPI 1083371629
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1770080046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 PICKERELL PL",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346552206",
            "telephone_number": "727-916-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33761",
            "telephone_number": "727-726-8871",
            "fax_number": "727-726-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNOS",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9282492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "HW88J",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Christine Walters, PTA
• Katrina Kaye Walton, RN
• Guansu Wang, AP
• Yi Chu Wang, MD
• Michael P Wanger, MD
• Irena Warchol
• Alexis Ward, APRN, FNP
• Marilyn Sue Ward, M.D.
• Andrew Wargo
• Warren Psychiatric Services

• Family Nurse Practitioner in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.