Individual provider Active NPI

Samantha Joann Campbell, DNP, FNCP, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1891260790
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
102249 Issued in OK
Practice address
9320 S Mingo Rd
Tulsa, OK 74133-5710
Phone
(918) 901-9701
NPI assigned
Oct 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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 102249 OK Primary

Addresses

Primary practice location

9320 S Mingo Rd
Tulsa, OK 74133-5710

Mailing address

9320 S Mingo Rd
Tulsa, OK 74133-5710
Phone (918) 901-9701

Other identifiers 1

IdentifierTypeStateIssuer
200844680AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20190716001015 OK Practitioner - Nurse Practitioner 3072848803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Pain of Tulsa PLLCGroup PAC ID 5890034144, 8 clinicians

Practice addresses (Care Compare)

9320 S Mingo Rd
Tulsa, OK 74133-5710
Phone (918) 901-9701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
57.52 of 100Reported as group
Quality
0
Improvement activities
40
Cost
77.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102249OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain of Tulsa PLLC CurrentSince Jun 20, 2019 Accepting new patients
Family Healthcare Clinic, Inc. PastSince Mar 3, 2024 Accepting new patients

Locations

9320 S Mingo Rd
Tulsa, OK 74133
Phone (918) 459-4000

Interoperability endpoints

  • Direct secure messaging: advancedpainoftulsa.samanthacampbell@141752.advancedmd-direct.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1891260790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 S MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335710",
            "telephone_number": "918-901-9701",
            "fax_number": "918-901-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 S MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335710",
            "telephone_number": "918-901-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SAMANTHA",
        "middle_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNCP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-06",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "102249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200844680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.