SAMANTHA MULLIS NNP
NPI 1003468844
Nurse Practitioner - Neonatal, Critical Care in Bend, OR

Q: What is Samantha Mullis's NPI number?

The NPI number for Samantha Mullis is 1003468844. It was assigned to this individual provider in the NPPES registry on July 11, 2019.

Q: What is Samantha Mullis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, Critical Care, with taxonomy code 363LN0005X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Mullis was last updated on April 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 11, 2019PECOS Enrolled

2500 NE NEFF RD, BEND, OR 97701(541) 382-4321(541) 706-7068 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2024, Jun 2, 2023, Jul 11, 2019 (3 updates tracked since 2019).

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About Samantha Mullis Nnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA MULLIS NNP (NPI 1003468844) is an individual neonatal, critical care provider in Bend, Oregon, licensed in North Carolina (5011980) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1003468844

Entity TypeIndividualFemale

Primary Taxonomy363LN0005X

Provider Legal NameSAMANTHA MULLISCredential: NNP

Location Address2500 NE NEFF RDBend, OR 97701-6015

Mailing Address200 Hawthorne LnCharlotte, NC 28204-2515 · (704) 384-4109

Phone(541) 382-4321

Fax(541) 706-7068

Sole ProprietorNo

Enumeration DateJuly 11, 2019

Last NPPES UpdateApril 1, 20243 updates tracked since enumeration

NPPES CertifiedApril 1, 2024

✔ NPI 1003468844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Neonatal, Critical CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LN0005X

License✔ Licensed in NC · 5011980

Also ListedNurse Practitioner · NeonatalTaxonomy 363LN0000X · License 5011980 (NC)

2500 NE NEFF RD, Bend, OR 97701

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Secondary Practice Location 1

Location 1200 Hawthorne LnCharlotte, NC 28204-2515 · Phone (704) 384-4109

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Mullis Nnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALANNA MOZENA MD

Internal Medicine