Samantha Zoltak, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3315 Issued in SC

Practice address

140 Allen CT
North Augusta, SC 29860-9782

Phone

(803) 510-0007

Fax

(803) 510-0144

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• North Augusta Pediatrics LLC

  • Rural Health Clinic/Center
  • North Augusta, SC
  • NPI 1194496745
  NPD
• North Augusta Pediatrics LLC

  • Pediatrics Physician
  • North Augusta, SC
  • NPI 1700068293
  NPD (past)

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1891344081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ALLEN CT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609782",
            "telephone_number": "803-510-0007",
            "fax_number": "803-510-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ALLEN CT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609782",
            "telephone_number": "803-510-0007",
            "fax_number": "803-510-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLTAK",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• X-Treme Health, PC
• Elizabeth Yonce
• Wayne R Yost, M.D.
• Sara H. Young, OT
• Wenhong Zheng

• Physician Assistant in North Augusta, SC
• Providers in North Augusta, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.