Individual provider Active NPI

Samantha Jo Colla

  • Acute Care Nurse Practitioner
  • Solon, OH
National Provider Identifier
1861094187
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0028584 Issued in OH
Practice address
27855 Tinkers Valley Dr
Solon, OH 44139-2161
Phone
(330) 718-5316
NPI assigned
Nov 11, 2020
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0028584 OH Primary
Oncology Registered Nurse 163WX0200X 404972 OH

Addresses

Primary practice location

27855 Tinkers Valley Dr
Solon, OH 44139-2161

Mailing address

27855 Tinkers Valley Dr
Solon, OH 44139-2161
Phone (330) 718-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220214000796 OH Practitioner - Nurse Practitioner 4082007158 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Akron General Medical CenterGroup PAC ID 8426961061, 117 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6047

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
404972OHMDOncology Registered Nurse
0028584OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center CurrentSince Nov 9, 2021 Accepting new patients
University Hospitals Ahuja Medical Center CurrentSince May 21, 2023 Accepting new patients
University Hospitals Ahuja Medical Center, Inc CurrentSince May 21, 2023 Accepting new patients
Akron General Medical Center CurrentSince Aug 5, 2024 Accepting new patients
Akron General Medical Center CurrentSince Aug 5, 2024 Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince Nov 9, 2021 Accepting new patients
University Hospitals Cleveland Medical Center Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

11100 Euclid Ave
Cleveland Heights, OH 44106

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 8

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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1861094187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27855 TINKERS VALLEY DR",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392161",
            "telephone_number": "330-718-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27855 TINKERS VALLEY DR",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392161",
            "telephone_number": "330-718-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLA",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "0028584",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "OH",
            "license": "404972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

Verify at the official NPI Registry.