Individual provider Active NPI

Samantha Merchant Hum, NP

  • Family Nurse Practitioner
  • Corona, CA
National Provider Identifier
1922610450
Registry record updated Oct 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029347 Issued in CA
Practice address
2250 S Main St Ste 201
Corona, CA 92882-2536
Phone
(951) 734-4880
NPI assigned
Aug 17, 2020
Last updated
Oct 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029347 CA Primary
Registered Nurse 163W00000X 95169312 CA

Addresses

Primary practice location

2250 S Main St Ste 201
Corona, CA 92882-2536

Mailing address

2250 S Main St Ste 201
Corona, CA 92882-2536
Phone (951) 734-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240417002643 CA Practitioner - Nurse Practitioner 0345689782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Physician Network, IncGroup PAC ID 4880910405, 8 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 201
Corona, CA 92882-2536
Phone (951) 621-3232

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029347CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Physician Network, Inc CurrentSince Apr 1, 2025 Accepting new patients
Corona Health Specialty Associates, LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

2250 S Main St
Ste 201
Corona, CA 92882
Phone (951) 621-3232

2250 S Main St
Ste 205
Corona, CA 92882
Phone (951) 734-2900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1922610450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-734-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-734-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUM",
        "first_name": "SAMANTHA",
        "middle_name": "MERCHANT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029347",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95169312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.