Individual provider Active NPI

Samantha Sollman, NP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1770211179
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71012893A Issued in IN
Practice address
309 N First Ave
Evansville, IN 47710-1218
Phone
(812) 450-4066
NPI assigned
Aug 12, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71012893A IN Primary

Addresses

Primary practice location

309 N First Ave
Evansville, IN 47710-1218

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

Other identifiers 1

IdentifierTypeStateIssuer
71012893AOtherINSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240131002570 IN Practitioner - Nurse Practitioner 3072998574 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Jan 8, 2024 Accepting new patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Jan 8, 2024 Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner Current Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner CurrentSince Apr 10, 2024 Accepting new patients
Deaconess Hospital Inc Nurse Practitioner CurrentSince Apr 10, 2024 Accepting new patients
Deaconess Clinic Inc. Nurse Practitioner Current Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4498 N 1st Ave
Evansville, IN 47710
Phone (812) 436-7280

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4011 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 858-2100

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: ssollman69399@direct.deaconess.com

Organizations & group practices 7

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": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1770211179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N FIRST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101218",
            "telephone_number": "812-450-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLMAN",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012893A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "71012893A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.