Individual provider Active NPI

Craig Hirsch Sampson, M.D.

  • Hospitalist Physician
  • Athens, GA
National Provider Identifier
1801821277
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
069040 Issued in GA
Practice address
1230 Baxter St
Athens, GA 30606
Phone
(706) 389-3410
Fax
(706) 389-3411
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 069040 GA
Hospitalist Physician 208M00000X 069040 GA Primary

Addresses

Primary practice location

1230 Baxter St
Athens, GA 30606

Mailing address

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 389-3410

Other practice location 1

4880 Lawrenceville Hwy
Suite 13
Tucker, GA 30084-2938
Phone (770) 864-9602

Other identifiers 1

IdentifierTypeStateIssuer
003147562AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000491 GA Practitioner - Internal Medicine 6800991159 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
069040GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Jan 1, 2015 Accepting new patients
Athens Hospitalist Services PC Hospitalist CurrentSince Aug 24, 2015 Accepting new patients
Tift Regional Health System Inc CurrentSince Jul 8, 2014 Accepting new patients
Tift Regional Health System Inc Internal Medicine CurrentSince Jul 8, 2014 Accepting new patients

Locations

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

1090 Experiment Station Rd
Unit 529
Watkinsville, GA 30677
Phone (706) 621-4108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1801821277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "706-389-3410",
            "fax_number": "706-389-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-389-3410",
            "fax_number": "706-389-3411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4880 Lawrenceville Hwy",
            "address_2": "Suite 13",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300842938",
            "country_code": "US",
            "telephone_number": "770-864-9602",
            "fax_number": "678-395-4585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "CRAIG",
        "middle_name": "HIRSCH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "069040",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "069040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147562A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.