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 |
| PAC ID |
5092248385 Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | SAMANTHA JANE SULLIVAN |
| Primary Specialty | NURSE PRACTITIONER |
| Organization Legal Name | FLORIDA CLINICAL PRACTICE ASSOCIATION INC |
| Address |
1505 Sw Archer Rd Gainesville FL 32608-1134 |
| 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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|---|---|---|---|
| Ernesto Regueira Lamas | 2804 Ne 25th St, Ocala, FL 34470-3987 | Nurse Practitioner | 2026-02-05 |
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| Devin Ashely Harrod | 1700 Whitehorse Hamilton Square Rd Ste D1, Hamilton Square, NJ 08690-3540 | Nurse Practitioner | 2026-02-06 |
| Quad Cities Integrative Wellness, LLC | 4622 Progress Dr Ste A, Davenport, IA 52807-3426 | Nurse Practitioner | 2026-02-06 |
| Annick Joseline Agah | 24 Durham Dr, Columbus, NJ 08022-2350 | Nurse Practitioner | 2026-02-06 |
| Sandra Erostico | 490 Illinois St Fl 9, San Francisco, CA 94143-2510 | Nurse Practitioner | 2026-02-06 |
| Jessica Valdman | 3321 Ne 165th St, North Miami Beach, FL 33160-3835 | Nurse Practitioner | 2026-02-06 |
| Candice Hamer | 22415 Manor Rd, Queens Village, NY 11427-2005 | Nurse Practitioner | 2026-02-05 |
| Npcwoods Telemedicine, PLLC | 7604 Highland Oaks Dr, Young Harris, GA 30582-2082 | Nurse Practitioner | 2026-02-07 |
| Wright Medical /Psychiatric Care LLC | 3624 Ensign Rd Ne Ste D, Olympia, WA 98506-5074 | Nurse Practitioner | 2026-02-05 |
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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 |
|---|---|---|---|
| Kennisha Brooke Miranda · Kennisha Brooke Darnell | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Family Nurse Practitioner | 2025-11-07 |
| Sydney Mckersie | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Pharmacist | 2025-10-14 |
| Chelsea Lynn Marchant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Family Nurse Practitioner | 2026-01-19 |
| George T. Singleton | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Otolaryngology Physician | 2006-07-21 |
| Kenneth Martin Borick Jr. | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Registered Nurse | 2026-01-31 |
| Evans George | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Pharmacist | 2026-01-15 |
| Josi Massimillo | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Student in an Organized Health Care Education/Training Program | 2026-01-19 |
| Johanna Del Castillo | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Pharmacist | 2025-12-23 |
| Sarah Shugan | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Student in an Organized Health Care Education/Training Program | 2025-11-25 |
| Courtlyn Ashlie Cannon | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | Physician Assistant | 2025-12-01 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Prachi Chetankumar Gajjar | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Internal Medicine Physician | 2022-05-02 |
| Kimberly Michelle Beavers | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Diagnostic Radiology Physician | 2015-06-19 |
| Karthik Chandrasekaran | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Gastroenterology Physician | 2019-03-18 |
| Ian Landis | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Diagnostic Radiology Physician | 2020-04-11 |
| Eduardo Javier Perez | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Hospitalist Physician | 2016-03-25 |
| Sewar Hisham Abuarqob | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Rheumatology Physician | 2020-08-20 |
| Anthony Dominic Sorrentino | 1600 Sw Archer Riad, Gainesville, FL 32610-3001 | Internal Medicine Physician | 2020-03-25 |
| Michael Joseph Gonzalez | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Diagnostic Radiology Physician | 2018-08-06 |
| Pooja Gurnani | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Dermatology Physician | 2021-03-27 |
| Ramez Maher Sameh Halaseh | 1600 Sw Archer Road, Gainesville, FL 32610-3001 | Internal Medicine Physician | 2019-06-16 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Michelle Patel | 1395 Center Dr Rm D1-30, Gainesville, FL 32610-0001 | Student in an Organized Health Care Education/Training Program | 2025-05-12 |
| Charlotte E Spellacy | 101 S. Newell Drive, Gainesville, FL 32610-0197 | Nurse Practitioner | 2005-11-23 |
| Ramez Azzam | 1600 Sw Archer Road, Gainesville, FL 32610 | Infectious Disease Physician | 2022-08-11 |
| Tareyn Morris | 1329 Sw 16th Street, Gainesville, FL 32610-0186 | Emergency Medicine Physician | 2018-05-22 |
| Lucy Jiang | Po Box 100176, Gainesville, FL 32610-0176 | Physician Assistant | 2025-05-23 |
| Shands Teaching Hospital and Clinics Inc | 1549 Gale Lemerand Dr., Rm 3500 3rd Floor, Gainesville, FL 32610 | Multi-Specialty Clinic/Center | 2025-05-01 |
| Abigail Thorndyke Shonrock | Po Box 100165, Gainesville, FL 32610-0165 | Clinical Psychologist | 2022-07-12 |
| Madelyn Frohm · Madelyn Justice | Po Box 100186, Gainesville, FL 32610-0186 | Physician Assistant | 2018-09-24 |
| Magera Shaw | Po Box 100275, Gainesville, FL 32610-0275 | Student in an Organized Health Care Education/Training Program | 2020-09-21 |
| Sally Edita Franco Palacios | 1600 Sw Archer Road Room 4102, Gainesville, FL 32610-0277 | Student in an Organized Health Care Education/Training Program | 2025-05-19 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Samantha Jane Dial | 46 Barra Rd Ste 101, Biddeford, ME 04005-9461 | Neurology Physician | 2011-06-20 |
| Samantha Jane Vestal · Samantha Jane Biben | 12 Chatham Heights Rd Ste 102, Fredericksburg, VA 22405-2593 | Physical Therapist | 2020-02-26 |
| Samantha Jane Evans | 6613 Milwaukee Ave, Lubbock, TX 79424-0619 | Behavioral Analyst | 2025-10-01 |
| Samantha Jane Small | 1040 W Bristol Rd, Flint, MI 48507-5516 | Case Management Agency | 2021-08-04 |
| Samantha Jane Faye | 7755 3rd St N Ste Oakdale, Oakdale, MN 55128-5442 | Behavior Technician | 2021-07-27 |
| Samantha Jane Figueiras | 8400 Red Bug Lake Rd Ste 1050, Oviedo, FL 32765-6835 | Gerontology Nurse Practitioner | 2018-02-06 |
| Samantha Jane Riley | 9331 N Dwight Ave, Portland, OR 97203-3583 | Community Health Worker | 2022-12-14 |
| Samantha Jane Riley | 3300 Grant Ave Ste 20, Philadelphia, PA 19114-2632 | Chiropractor | 2025-10-15 |
| Samantha Jane Haling | 10431 Patterson Ave, Richmond, VA 23238-5101 | Professional Counselor | 2023-11-17 |
| Samantha Jane Rook | 12222 Merit Dr Ste 600, Dallas, TX 75251-3294 | Certified Registered Nurse Anesthetist | 2025-09-25 |
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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. |