Samantha Audrey McDougal, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2400 Issued in NV

Practice address

1475 Medical Pkwy
Carson City, NV 89703-4635

Phone

(775) 883-3636

Fax

(775) 882-2382

NPI assigned

Jun 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Physician Assistant

Education

University of Nevada School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carson Medical Group Professional CorporationGroup PAC ID 4183520778, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Carson Medical Group Professional Corporation

  • Family Medicine Physician
  • Carson City, NV
  • NPI 1780694620
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1821656174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 OLD HOT SPRINGS RD",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897060674",
            "telephone_number": "775-882-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034635",
            "telephone_number": "775-883-3636",
            "fax_number": "775-882-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGAL",
        "first_name": "SAMANTHA",
        "middle_name": "AUDREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bruce McCullough, PTA
• Tanya McCullough
• Mynet McDermott, CADC INTERN
• Robert Lewis McDonald, MD
• Ryann McDonald, CCC-SLP
• Jasmine L McDowell
• Matthew Paul McDowell, DO
• Susan Catherine McElhany, DMD
• Joseph Edward McEllistrem, PH.D.
• Kathleen Ann McElroy, PA-C

• Medical Physician Assistant in Carson City, NV
• Providers in Carson City, NV by specialty
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.