SAMANTHA ROXANNE POLSTON APRN
NPI 1033708649
Nurse Practitioner - Family in Bowling Green, KY

Q: What is Samantha Polston's NPI number?

The NPI number for Samantha Polston is 1033708649. It was assigned to this individual provider in the NPPES registry on January 18, 2021.

Q: What is Samantha Polston's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Polston was last updated on June 24, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 18, 2021PECOS Enrolled

1801 ASHLEY CIR, BOWLING GREEN, KY 42104(270) 793-1000 Get Directions Write a Review

NPPES record last updated: June 24, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 24, 2021, Jan 18, 2021 (2 updates tracked since 2021).

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About Samantha Roxanne Polston Aprn NPPES

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

SAMANTHA ROXANNE POLSTON APRN (NPI 1033708649) is an individual family provider in Bowling Green, Kentucky, licensed in Kentucky (3016188) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033708649

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA ROXANNE POLSTONCredential: APRN

Location Address1801 ASHLEY CIRBowling Green, KY 42104-3362

Mailing Address433 Robin Hood TrlBowling Green, KY 42101-4220 · (270) 459-0794

Phone(270) 793-1000

Sole ProprietorNo

Enumeration DateJanuary 18, 2021

Last NPPES UpdateJune 24, 20212 updates tracked since enumeration

NPPES CertifiedJune 24, 2021

✔ NPI 1033708649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 3016188

Also ListedRegistered NurseTaxonomy 163W00000X · License 1149077 (KY)

1801 ASHLEY CIR, Bowling Green, KY 42104

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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 Roxanne Polston Aprn 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 42104 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

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