Ashley Samaniego, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5020715 Issued in NC

Practice address

2204 Pavilion Dr Ste 107
Kingsport, TN 37660-4651

Phone

(423) 343-1442

Fax

(423) 722-3009

NPI assigned

Jun 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ashley Mitcham Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment Care Compare group NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1326058272
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1902583917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR STE 107",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604651",
            "telephone_number": "423-343-1442",
            "fax_number": "423-722-3009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Med Tech Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042365",
            "country_code": "US",
            "telephone_number": "423-302-3480",
            "fax_number": "423-722-3009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046034",
            "country_code": "US",
            "telephone_number": "423-431-7111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Med Tech Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042371",
            "country_code": "US",
            "telephone_number": "423-302-3480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Towerview Ct",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275133595",
            "country_code": "US",
            "telephone_number": "919-585-5085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "ASHLEY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5020715",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36562",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "180297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MITCHAM",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Halie Salyers
• Justin Salyers
• Timothy Edward Salyers, D.C.
• Sam W. Huddleston IV MD PC
• Sam'S Club Optical
• Stacey L Sampson
• Elijah Todd Samsel, FNP
• Jonmichael Samsel, DO
• B Jeffrey Sanders, MD
• Holly A Sanders, MD

• Psychiatric/Mental Health Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.