Samantha Rae Lynn, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Bolt, WV
NPI 1891668166 · NPPES record last updated Sep 24, 2025
Key facts
- NPI
- 1891668166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 124301 (WV)
- Practice address
- PO Box 423
Bolt, WV 25817-0423 - Phone
- (304) 673-1986
- NPI assigned
- Sep 24, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Evolutionary Healthcare West Virginia PLLC
Practice addresses (Care Compare)
979 Rocky Hill Rd
Ronceverte, WV 24970-8028
Phone (321) 387-9451
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260320003220 | WV | Practitioner - Nurse Practitioner | 2567946130 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124301 | WV | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 124301 | WV | Yes |
Addresses
Primary practice location
PO Box 423
Bolt, WV 25817-0423
Mailing address
PO Box 423
Bolt, WV 25817-0423
Other providers in Bolt, WV
- Macie Adkins
- Tammy Lynn Ashmore
- Cassandra Graham
- Nancy Louise Lane
- Mary McGraw
- Allison Pugh
- Montana Faith Stewart
- Nancy Webb
All providers in Bolt, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.