Individual provider Active NPI

Samantha Ann Wilkinson, PC-PNP

  • Pediatric Nurse Practitioner
  • Richmond Hill, GA
National Provider Identifier
1992354443
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN-NP213158 Issued in GA
Practice address
89 Interchange Dr
Richmond Hill, GA 31324-7664
Phone
(912) 527-5352
Fax
(912) 756-5291
NPI assigned
Sep 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN-NP213158 GA Primary

Addresses

Primary practice location

89 Interchange Dr
Richmond Hill, GA 31324-7664

Mailing address

89 Interchange Dr
Richmond Hill, GA 31324-7664
Phone (912) 527-5352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200224002278 GA Practitioner - Nurse Practitioner 9537596994 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP213158GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Jan 1, 2020 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

89 Interchange Dr
Richmond Hill, GA 31324
Phone (912) 527-5301

10055 Ford Ave
Ste 4A
Richmond Hill, GA 31324
Phone (912) 527-5352

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: samantha.wilkinson.1@8042.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1992354443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 INTERCHANGE DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247664",
            "telephone_number": "912-527-5352",
            "fax_number": "912-756-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 INTERCHANGE DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247664",
            "telephone_number": "912-527-5352",
            "fax_number": "912-756-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PC-PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-07",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP213158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, GA

Sources for this page

Verify at the official NPI Registry.