NPIMap

Individual provider Active NPI

Samantha Niesen, FNP-C

  • Nurse Practitioner
  • Soldotna, AK
National Provider Identifier
1982446928
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
225625 Issued in AK
Practice address
247 N Fireweed St
Soldotna, AK 99669-7540
Phone
(907) 262-8597
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 117543 AK
Nurse Practitioner 363L00000X 225625 AK Primary

Addresses

Primary practice location

247 N Fireweed St
Soldotna, AK 99669-7540

Mailing address

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smulvaney779799@ak.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924004796 AK Practitioner - Nurse Practitioner 6103367610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

247 N Fireweed St
Suite a
Soldotna, AK 99669-7593
Phone (907) 262-8597

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117543AKMDRegistered Nurse
225625AKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Peninsula General Hospital Inc. Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Jul 1, 2024 Accepting new patients
North Star Medical Imaging PLLC Current Accepting new patients
Central Peninsula General Hospital Inc CurrentSince Jul 1, 2024 Accepting new patients
Central Peninsula General Hospital, Inc Past Accepting new patients

Locations

247 N Fireweed St
Ste A
Soldotna, AK 99669
Phone (907) 262-8597

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Interoperability endpoints

  • Direct secure messaging: smulvaney779799@ak.providencedirect.org

Organizations & group practices 5

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1982446928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540",
            "telephone_number": "907-262-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESEN",
        "first_name": "SAMANTHA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "117543",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "225625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smulvaney779799@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging address",
            "address_1": "247 N Fireweed St",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.