Individual provider Active NPI

Samantha Noah

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1982152377
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3405522 Issued in FL
Practice address
1121 NW 64TH Ter
Suite a
Gainesville, FL 32605-4243
Phone
(352) 331-3583
Fax
(352) 331-3669
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3405522 FL Primary

Addresses

Primary practice location

1121 NW 64TH Ter
Suite a
Gainesville, FL 32605-4243

Mailing address

1121 NW 64TH Ter
Suite a
Gainesville, FL 32605-4243
Phone (352) 331-3583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161222000071 FL Practitioner - Nurse Practitioner 7618258187 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison County Hospital Health Systems IncGroup PAC ID 2860474111, 12 clinicians
SMD EMS Group LLCGroup PAC ID 8224517511, 11 clinicians

Practice addresses (Care Compare)

224 NW Crane Ave
Madison, FL 32340-1400
Phone (850) 253-1923

Hospital & facility affiliations

  • Madison County Memorial Hospital Hospital, Madison, FL, CCN 101311

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Madison County Hospital Health Systems, Inc. CurrentSince Aug 23, 2024 Accepting new patients
FL-I Medical Services LLC Nurse Practitioner CurrentSince Nov 1, 2017 Accepting new patients
Madison County Hospital Health Systems, Inc. CurrentSince Aug 23, 2024 Accepting new patients
North Meridian Medical Services Corporation CurrentSince Jan 22, 2022 Accepting new patients
SMD EMS Group LLC CurrentSince Dec 22, 2025 Accepting new patients
Southland EMS at Madison, PLLC CurrentSince Feb 1, 2023 Accepting new patients
FL-I Medical Services, LLC Nurse Practitioner Current Accepting new patients
FL-I Medical Services LLC Nurse Practitioner CurrentSince Nov 1, 2017 Accepting new patients
West Florida Specialty Physicians LLC PastSince Jan 13, 2020 Accepting new patients

Locations

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

224 NW Crane Ave
Madison, FL 32340
Phone (850) 253-1923

Organizations & group practices 9

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.

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": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1982152377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 NW 64TH TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054243",
            "telephone_number": "352-331-3583",
            "fax_number": "352-331-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 NW 64TH TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054243",
            "telephone_number": "352-331-3583",
            "fax_number": "352-331-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOAH",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3405522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.