Samantha Jane Sullivan is a Nurse Practitioner practicing in Gainesville, Florida. The National Provider Identifier (NPI) is #1508600859, which was assigned on June 21, 2024, and the registration record was last updated on December 12, 2024. The practitioner's main practice location is at 1600 Sw Archer Rd, Gainesville, FL 32610-3001; the contact telephone number is 3522739079. The primary taxonomy of Samantha Jane Sullivan is Nurse Practitioner (363L00000X). Samantha Jane Sullivan is licensed to practice in the state of Florida (#11033413).
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
| NPI | 1508600859 |
| Entity Type | Individual |
| Provider Name | SAMANTHA JANE SULLIVAN |
| Other Name |
SAMANTHA JANE AVALOS (Former Name) |
| Gender | Female |
| Credential | APRN |
| Practice Address |
1600 Sw Archer Rd Gainesville FL 32610-3001 |
| Practice Telephone | 3522739079 |
| Mailing Address |
Po Box 100288 Gainesville FL 32610-0277 |
| Mailing Telephone | 3522739079 |
| Certification Date | 2024-12-12 |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-12-12 |
| Is Sole Proprietor | N |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 11033413 | FL |
| Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| Classification | Nurse Practitioner |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses' Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
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|---|---|---|---|
| Monique Hazel Sendayen Domalanta | 6975 Paradise Valley Rd Apt 86, San Diego, CA 92139-1267 | Nurse Practitioner | 2025-03-07 |
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| Teri Ann Vignola | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | Nurse Practitioner | 2025-03-05 |
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| Hannah Olivia Brown | 201 Governors Dr Sw Ste 300&400, Huntsville, AL 35801-5170 | Nurse Practitioner | 2025-03-06 |
| Mary Elizabeth Reed | 701 S Nedderman Dr, Arlington, TX 76019-9800 | Nurse Practitioner | 2025-03-07 |
| Serita Scullark | 480 Bedford Rd, Chappaqua, NY 10514-1715 | Nurse Practitioner | 2025-03-07 |
| Apollo Medical Wound Care LLC | 4161 Oceanside Blvd Ste 5, Oceanside, CA 92056-6035 | Nurse Practitioner | 2025-03-08 |
| Alyssa Rose Doherty | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Nurse Practitioner | 2025-03-08 |
| Samina Fitch | 517 Colorado Ave, Pueblo, CO 81004-2075 | Nurse Practitioner | 2025-03-07 |
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| Street Address |
1600 SW ARCHER RD |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32610-3001 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Adrienne M Orriols | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Student in an Organized Health Care Education/Training Program | 2025-02-25 |
| Bruna Cavalcanti Sarkisian | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Critical Care Medicine Registered Nurse | 2025-02-26 |
| Sara Elizabeth Contreras | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Student in an Organized Health Care Education/Training Program | 2025-03-06 |
| Samiya Grant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Anesthesiologist Assistant | 2025-01-31 |
| Juan Camilo Castro Carvajal | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Diagnostic Radiology Physician | 2025-02-19 |
| Alexandra Marie English · Alexandra Eheman | 1600 Sw Archer Rd, Gainesville, FL 32610-5304 | Nurse Practitioner | 2025-01-31 |
| Amanda Marthenze | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Neonatal Nurse Practitioner | 2025-02-20 |
| Hyun Bak | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Registered Nurse | 2024-12-17 |
| Frederick Briones Ramos | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Medical-Surgical Registered Nurse | 2024-11-05 |
| Melissa Liptrap · Melissa Manning | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Pediatric Nurse Practitioner | 2024-12-04 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Sang Hee Min | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Hematology & Oncology Physician | 2008-07-03 |
| Kimberly Michelle Beavers | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Diagnostic Radiology Physician | 2015-06-19 |
| Janelle C Wilkinson | 1600 Sw Archer Road- Suite N1-07, University of Florida Community Health & Family Medicin, Gainesville, FL 32610-3001 | Family Medicine Physician | 2016-05-13 |
| Kubra Melek Tuna | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Endocrinology, Diabetes & Metabolism Physician | 2019-03-27 |
| Shahrukh Bengali | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Anesthesiology Physician | 2019-04-03 |
| Neelesh Jain | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Dermatology Physician | 2019-05-24 |
| Jennifer Parnaz Huckabee · Jennifer Parnaz Borojerdi | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Diagnostic Radiology Physician | 2013-04-12 |
| Gahyun Gim | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Student in an Organized Health Care Education/Training Program | 2018-06-29 |
| Eduardo Javier Perez | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Interventional Cardiology Physician | 2016-03-25 |
| Justin Neil Reed | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Internal Medicine Physician | 2011-05-10 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| James Joseph Reilly | Universit Y of Florida, 101 South Newell Drive, Gainesville, FL 32610 | Speech-Language Pathologist | 2008-09-09 |
| John Harry Grebe | 1600 Sw Archer, Gainesville, FL 32610 | Pediatrics Physician | 2006-10-17 |
| Mason Lin | 1600 Sw Archer Road, Gainesville, FL 32610 | Student in an Organized Health Care Education/Training Program | 2024-03-28 |
| Mitali Girish Chitre | 1395 Center Drive Room # D1 - 30, University of Fl College of Dentistry, Gainesville, FL 32610 | Orthodontics and Dentofacial Orthopedic Dentist | 2022-06-13 |
| Tyler Williams | 1600 Archer Road, Gainesville, FL 32610 | Student in an Organized Health Care Education/Training Program | 2023-04-04 |
| Tania M. Holly | Uf, Department of Psychiatry 1600 Sw Archer Road, Gainesville, FL 32610 | Psychiatric Hospital Unit | 2006-11-24 |
| Alejandro Jose Delgado | 1395 Center Drive, University of Florida, College of Dentistry, Gainsville, FL 32610 | Dentist | 2014-07-01 |
| Mo'Ath Issam Abdellatif Bani Salem | 1600 Sw Archer Road, Gainesville, FL 32610 | Student in an Organized Health Care Education/Training Program | 2024-05-21 |
| Eduardo Walker | 1600 Sw Archer Road, Shands Hospital, Gainsville, FL 32610 | Student in an Organized Health Care Education/Training Program | 2022-04-26 |
| Nakia Smith | 100 Newell Dr Ste L3-100, Gainesville, FL 32610 | Neurology Physician | 2013-06-14 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Samantha Jane Schouweiler · Samantha Jane Hoffman | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | Physician Assistant | 2018-02-23 |
| Samantha Jane Birrenkott | 301 Broadway, Napoleon, ND 58561-7010 | Case Manager/Care Coordinator | 2014-03-25 |
| Samantha Jane Birks | 98 Shaker Rd, East Longmeadow, MA 01028-2731 | Physician Assistant | 2024-06-12 |
| Samantha Jane Rea | 6206 Commerce Palms Dr, Tampa, FL 33647-1506 | Family Nurse Practitioner | 2023-10-18 |
| Samantha Jane Jones | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | Licensed Psychiatric Technician | 2016-05-19 |
| Samantha Jane Wetzel · Samantha Jane Raidt | 2000 Foundation Way Ste 1200, Martinsburg, WV 25401-9030 | Speech-Language Pathologist | 2022-05-18 |
| Samantha Jane Ball · Samantha Workman | 135 4th Ave, Huntington, WV 25701-1219 | Licensed Vocational Nurse | 2024-03-14 |
| Samantha Jane Gierke · Samantha Jane Rauch | 112 Helen St, Sauk City, WI 53583-1168 | Physician Assistant | 2021-05-04 |
| Samantha Jane Speir · Samantha Jane Bates | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | Mental Health Counselor | 2013-09-19 |
| Samantha Jane Shiney · Samantha Jane Sharac | 2600 Redondo Ave Fl 4, Long Beach, CA 90806-2325 | Clinical Psychologist | 2009-08-12 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |