Samantha L Munro

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209028045 Issued in IL

Practice address

2236 Vadalabene Dr
Maryville, IL 62062-5844

Phone

(618) 726-2229

NPI assigned

Sep 22, 2023

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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.

• Christina H Dothager MD LLC

  • Clinic/Center
  • O Fallon, IL
  • NPI 1740776251
  Medicare reassignment NPD

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1942089768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 SUNSET BLVD",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-726-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625844",
            "telephone_number": "618-726-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNRO",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Msa Alliance, LLC
• Msa Alliance, LLC
• Msa Alliance, LLC Dba-Southern Illinois Vascular and Vein Surgery
• Laura Beth Mulcahy, CNM
• Natale S. Muniz, OT
• Michael L. Murphy, DMD
• Patrick Murphy, D.M.D.
• Marla Marie Musso, PHARM.D
• Robin L. Myers, PSY.D.
• Srikanth Nadella, M.D.

• Family Nurse Practitioner in Maryville, IL
• Providers in Maryville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.