Individual provider Active NPI

Nicole Lynn Samies, DO

  • Pediatric Infectious Diseases Physician
  • Danville, PA
National Provider Identifier
1912399510
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
OS021187 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-1711
Phone
(570) 271-6211
NPI assigned
Feb 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO.1830 AL
Pediatrics Physician 208000000X OS021187 PA
Pediatric Infectious Diseases Physician 2080P0208X DO.1830 AL
Pediatric Infectious Diseases Physician 2080P0208X OS021187 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-1711

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191017002924 AL Practitioner - Pediatric MedicinePractitioner - Infectious Disease 5193029577 Reassigns benefits to 1 organization
I20210713000182 PA Practitioner - Pediatric Medicine 5193029577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DO.1830ALMDPediatric Infectious Diseases Physician
OS021187PAMDPediatric Infectious Diseases Physician
1830ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 2, 2021 Accepting new patients
Geisinger Clinic CurrentSince Aug 2, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Aug 7, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 7, 2019 Accepting new patients
Geisinger Medical Center Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

1600 7th Ave S
#308
Birmingham, AL 35233

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: nsamies123576@direct.geisinger.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1912399510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178221711",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMIES",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "DO.1830",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS021187",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "AL",
            "license": "DO.1830",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "PA",
            "license": "OS021187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.