Individual provider Active NPI

Samantha Marie Barraclough, PA

  • Physician Assistant
  • Phenix City, AL
National Provider Identifier
1780232819
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13521 Issued in GA
Practice address
1810 Stadium Dr Ste 240
Phenix City, AL 36867-3179
Phone
(334) 297-4883
NPI assigned
Sep 2, 2019
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13521 GA Primary

Addresses

Primary practice location

1810 Stadium Dr Ste 240
Phenix City, AL 36867-3179

Mailing address

104 Woodmont Blvd Ste 500
Nashville, TN 37205-2245
Phone (888) 802-9885

Other practice location 1

1211 Cushman St
Fairbanks, AK 99701-4680
Phone (907) 328-0989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20191111000844 NY Practitioner - Physician Assistant 1759713928 Reassigns benefits to 1 organization
I20260318004094 GA Practitioner - Physician Assistant 1759713928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1538 13TH Ave
Suite B400
Columbus, GA 31901-2564
Phone (706) 321-9300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023900NYMDCognitive & Behavioral Psychologist
13521GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Jan 1, 2026 Accepting new patients

Locations

1810 Stadium Dr
Ste 240
Phenix City, AL 36867
Phone (334) 291-8303

1538 13th Ave
Ste B400
Columbus, GA 31901
Phone (706) 323-4000

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

Organizations & group practices 3

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.

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": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1780232819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245",
            "telephone_number": "888-802-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 STADIUM DR STE 240",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368673179",
            "telephone_number": "334-297-4883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Cushman St",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997014680",
            "country_code": "US",
            "telephone_number": "907-328-0989",
            "fax_number": "855-259-0324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRACLOUGH",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-02",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

Verify at the official NPI Registry.