Individual provider Active NPI

Brianna Lynn Sample, DNP, FNP-BC

  • Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1972173813
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN258419 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-4193
Phone
(706) 721-4400
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.25142 SC
Family Nurse Practitioner 363LF0000X RN258419 SC
Nurse Practitioner 363L00000X RN258419 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-4193

Mailing address

6668 Crawford Place Rd
Appling, GA 30802-2327
Phone (269) 370-8429

Other practice location 1

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 228-1370

Other practice location 2

1000 Clyburn Pl
Aiken, SC 29801-4193
Phone (803) 380-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bsample605430@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240228000431 SC Practitioner - Nurse Practitioner 5698110815
I20241231000324 GA Practitioner - Nurse Practitioner 5698110815 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.25142SCMDFamily Nurse Practitioner
RN258419SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 15, 2024 Accepting new patients
Au Medical Associates Inc Past Accepting new patients
HHC Augusta, Inc Past Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 4

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": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1972173813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6668 CRAWFORD PLACE RD",
            "city": "APPLING",
            "state": "GA",
            "postal_code": "308022327",
            "telephone_number": "269-370-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309124193",
            "telephone_number": "706-721-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Walton Way",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012612",
            "country_code": "US",
            "telephone_number": "706-228-1370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Clyburn Pl",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298014193",
            "country_code": "US",
            "telephone_number": "803-380-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "BRIANNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN.25142",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "RN258419",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN258419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bsample605430@directwellstar.org",
            "affiliation": "N",
            "address_1": "1120 15th St",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309124193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.