Individual provider Active NPI

Samantha Marie Harrison

  • Family Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1790465763
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1090663 Issued in TX
Practice address
1317 Imperial Blvd
McKinney, TX 75071-2560
Phone
(626) 840-4591
NPI assigned
Jul 24, 2023
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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 1090663 TX Primary

Addresses

Primary practice location

1317 Imperial Blvd
McKinney, TX 75071-2560

Mailing address

1317 Imperial Blvd
McKinney, TX 75071-2560
Phone (626) 840-4591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241115002459 TX Practitioner - Nurse Practitioner 2769916543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

3821 W Spring Creek Pkwy
Plano, TX 75023-3808
Phone (972) 599-0077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1090663TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Physicians, PLLC CurrentSince Sep 7, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

104 S Main St
Keller, TX 76248
Phone (214) 295-9385

3821 W Spring Creek Pkwy
Plano, TX 75023
Phone (972) 599-0077

377 W Campbell Rd
Ste 100
Richardson, TX 75080
Phone (469) 232-2945

Organizations & group practices 1

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1790465763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 IMPERIAL BLVD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750712560",
            "telephone_number": "626-840-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 IMPERIAL BLVD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750712560",
            "telephone_number": "626-840-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1090663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.